Author: Dr Clemens

Uncategorized Published - 23 June, 2022    By - Dr Clemens
Enhancing Patient Communications Program, Part 2: Communicating Information to Patients Clearly Begins with Establishing Expectations

Author: Asha Padmanabhan, MD, FASA ASA Monitor June 2022, Vol. 86, 13–14. Communicating Information to the Patient Clearly and at the Correct Times Throughout the Perioperative Journey is the second of a four-part series that provides more information and insight about ASA’s Enhancing Patient Communications Program. When first meeting with patients who are about to have surgery, […]

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Uncategorized Published - 23 June, 2022    By - Dr Clemens
Anesthesia Incident Reporting System (AIRS) Case 2022-06: Blowing Bubbles

ASA Monitor June 2022, Vol. 86, 9. The Anesthesia Incident Reporting System (AIRS) has been in operation for 10 years, with thousands of detailed reports and tens of thousands of reports letting us know that an anesthetic was associated with a complication. AIRS uniquely serves as a “canary in the coal mine,” giving our specialty […]

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Uncategorized Published - 23 June, 2022    By - Dr Clemens
SEE Question

ASA Monitor June 2022, Vol. 86, 12. According to a recent population-based study, which of the following MOST likely describes the associated risk of autism spectrum disorder in offspring when epidural labor analgesia is used? □ (A) Increased □ (B) Decreased □ (C) No association Autism spectrum disorder is a developmental condition that is present in […]

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Uncategorized Published - 23 June, 2022    By - Dr Clemens
Long COVID Revisited

Authors: Richard Simoneaux; Steven L. Shafer, MD, FASA ASA Monitor June 2022, Vol. 86, 1–5. Shortly after SARS-CoV-2 began spreading worldwide in early 2020, clinicians noted that some seemingly recovered patients had prolonged neurological, cardiovascular, and metabolic sequelae. The syndrome was given various names, including “long-haul COVID,” “long COVID,” and “post-acute COVID-19.” Over the past two […]

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Uncategorized Published - 22 June, 2022    By - Dr Clemens
Crossing the Finish Line: Post-Discharge Care of Ambulatory Surgical Patients

Authors: Jaime B. Hyman, MD; Jinlei Li, MD, PhD ASA Monitor June 2022, Vol. 86, 33–34. With sicker patients undergoing ever-more complex surgical procedures, the post-discharge period deserves increased attention. Recovery has shifted from the hospital to the home, and caregiving has shifted from health care workers to non-medical family or friends. Optimized post-discharge analgesia and nausea […]

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Uncategorized Published - 22 June, 2022    By - Dr Clemens
Inadequately Treated Post-Discharge Adverse Events After Ambulatory Surgery: Nausea, Pain, and Pruritus

Author: Uday Jain, BSEE, MD, PhD, FASA ASA Monitor June 2022, Vol. 86, 31–32. Nausea, pain, and pruritus have a high degree of prevalence and severity after discharge following ambulatory surgery, for which they may be inadequately treated. Nausea and vomiting Incidence In a multicenter study of over 2,000 U.S. adults, the overall incidence of post-discharge […]

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Uncategorized Published - 22 June, 2022    By - Dr Clemens
Purging ‘Clearance’ from Our Lexicon

Authors: Sarah G. Bodin, MD, FASA ASA Monitor June 2022, Vol. 86, 30. Today I reviewed another “low-risk clearance” checkbox note from an advanced practice registered nurse, for a topical cataract case, under monitored anesthesia care. Prior to the patient’s topical cataract extraction, my healthy 64-year-old patient had visited her primary care physician to be cleared […]

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Uncategorized Published - 22 June, 2022    By - Dr Clemens
The Pediatric Patient for Ambulatory Surgery: Challenges on the Horizon

Author: Niraja Rajan, MBBS, FAAP, SAMBA-F, FASA ASA Monitor June 2022, Vol. 86, 28–29. Many pediatric surgeries are performed on an outpatient basis either in a hospital or a freestanding ambulatory surgery center (ASC) with tonsillectomy and/or adenoidectomy, myringotomy, appendectomy, urological procedures, and other operating room therapeutic procedures on nose, mouth, and pharynx accounting for the […]

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Uncategorized Published - 22 June, 2022    By - Dr Clemens
ACE Question

ASA Monitor June 2022, Vol. 86, 11. Three minutes after administering a standard intubating dose of rocuronium (0.6 mg/kg) to a patient with cirrhosis, you discover the vocal cords are closed during laryngoscopy and the patient is moving. An alteration in which of the following MOST likely explains this finding? □ (A) Hepatic clearance □ (B) The neuromuscular […]

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Uncategorized Published - 21 June, 2022    By - Dr Clemens
Basal Infusion versus Automated Boluses and a Delayed Start Timer for “Continuous” Sciatic Nerve Blocks after Ambulatory Foot and Ankle Surgery

Authors: John J. Finneran, IV, M.D. et al  Anesthesiology June 2022, Vol. 136, 970–982. Background The common technique using a basal infusion for an ambulatory continuous peripheral nerve blocks frequently results in exhaustion of the local anesthetic reservoir before resolution of surgical pain. This study was designed to improve and prolong analgesia by delaying initiation using […]

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