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Authors: Laurent Brochard, M.D. et al Anesthesiology October 2018. “How can we determine when mechanical ventilation is harming the lung…?” VENTILATOR-INDUCED lung injury is a multifaceted problem that has progressively become a preoccupation for intensivists and anesthesiologists. It has taken many years to realize that mechanical ventilation, a life-saving technique, could also induce harm. The first […]
Read MoreASA Monitor 11 2018, Vol.82, 52-55. A 48-year-old man with a history of severe depression, former heroin use and chronic low back pain presents for elective minor scar revision surgery. He is taking 8 mg of buprenorphine sublingually daily, and a recent urine screen was negative for illicit substances. Which of the following is the best course of […]
Read MoreASA Monitor 11 2018, Vol.82, 50-51. Review of unusual patient care experiences is a cornerstone of medical education. Each month, the AQI-AIRS Steering Committee abstracts a patient history submitted to the Anesthesia Incident Reporting System (AIRS) and authors a discussion of the safety and human factors challenges involved. Real-life case histories often include multiple clinical decisions, […]
Read MoreASA Monitor 11 2018, Vol.82, 44. Which of the following characteristics is most likely in a neonate with a gastroschisis rather than an omphalocele? (A) Congenital heart disease (B) Inborn errors of metabolism (C) Absence of coverage with a membranous sac (D) Urologic abnormalities Omphalocele (Figure 1) and gastroschisis (Figure 2) represent two of the more common neonatal […]
Read MoreAuthors: Stephen H. Jackson, M.D. ASA Monitor 11 2018, Vol.82, 24-27. Ethical Principles and Informed Consent1-3 The ethical implications of routine (“screening,” non-con-sented) preoperative pregnancy testing often are obscured by scientific and legal misinformation that creates unfounded uncertainty. The process of informed consent honors what the patient wants through respecting the ethical principle of patient autonomy (self-determination). Ethically, a woman has the right to be offered pregnancy […]
Read MoreAuthors: Michael Souter, M.B., Ch.B., FRCA, FNCS ASA Monitor 11 2018, Vol.82, 20-22. Michael Souter, M.B., Ch.B., FRCA, FNCS, is Professor of Anesthesiology and Pain Medicine and Neurological Surgery/Chief of Anesthesia Services (HMC), Harborview Medical Center, University of Washington, and Medical Director, LifeCenter Northwest (Organ Procurement Organization), Seattle. Prior to a consensus on the definition of […]
Read MoreAuthors: Krishnan S. Ramanujan, M.D. et al ASA Monitor 11 2018, Vol.82, 16-18. The opioid epidemic is one of the largest and most recent public health crises to strike the United States, with the rate of opioid-related overdose deaths nearly quadrupling between 1999 and 2014. To combat this growing epidemic, research has been conducted to identify those […]
Read MoreAuthors: Jeffrey S. Jacobs, M.D., M.B.A., FASA et al ASA Monitor 11 2018, Vol.82, 14-15. It’s another day in the O.R. with another day of surprises. Lately, however, the revelations aren’t the medical complexities of the patient or the cause of O.R. delay (never anesthesia, of course). For too long, the primary question has been, “what medications […]
Read MoreAuthors: Dominic S. Carollo, M.D. et al ASA Monitor 11 2018, Vol.82, 10-13. This article is excerpted in part from “Fundamentals of the Pediatric Informed Consent Process.”1 The process of obtaining informed consent for a pediatric patient is distinctly different from the adult patient. Competent patients (i.e., adults with decision-making capacity) act autonomously in the process of […]
Read MoreThe Drug Enforcement Administration (DEA) recently released an alert warning of an extortion scam targeting DEA registrants, including anesthesiologists and CRNAs. Members are encouraged to be careful to avoid being impacted by the scam. According to the DEA, individuals are receiving telephone calls and emails from persons who identify themselves as DEA employees or other […]
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