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ASA Monitor February 2022, Vol. 86, 20. What We’ve Got Here Is Failure to Communicate A first dose of ketorolac was given early by a different provider. After scanning the ketorolac at the end of the case, I did not confirm that any had already been administered. The error was discovered during handoff as I […]
Read MoreAuthor: Kelly Wolfgang Jong ASA Monitor February 2022, Vol. 86, 19. Recent studies have shown a link between intraoperative hypotension (IOH) and injury to the patient, from acute kidney injury (AKI) and adverse cardiac events to inadequate organ perfusion. Though the data suggest that a link exists, there is not yet clear evidence of a causal […]
Read MoreASA Monitor February 2022, Vol. 86, 3. The following capnogram is MOST likely associated with which of the following? □ (A) Faulty inspiratory valve □ (B) Partially obstructed endotracheal tube □ (C) Leak in sampling line The time capnogram (Figure 1) can provide evidence of certain disease states and equipment issues. A faulty inspiratory valve makes […]
Read MoreAuthors: Alexander J. Rodriguez, MD and Christian O’Donnell, MD ASA Monitor February 2022, Vol. 86, 41. In anesthesia, the patient relationship typically ends once the operation is over. In internal medicine, it often begins well before or after a patient begins their surgical journey. Combined training in internal medicine and anesthesiology prepares one to tackle essentially […]
Read MoreASA Monitor February 2022, Vol. 86, 15. A patient undergoing major thoracic surgery has a urine output of 0.2 mL/kg/h. According to a recent study defining oliguria as a urine output less than 0.3 mL/kg/h, which of the following statements BEST describes the impact of urine output on the risk of postoperative acute kidney injury […]
Read MoreAuthors: Rachel Hadler, MD and Shahla Siddiqui, MD, MS, D.ABA, FCCM ASA Monitor February 2022, Vol. 86, 27–28. Case: A 65-year-old man with a previous medical history of hypertension, hyperlipidemia, and obesity is diagnosed with renal cell carcinoma with associated inferior vena cava (IVC) thrombus and concern for pulmonary metastases. He presents to the OR for nephrectomy […]
Read MoreAuthors: Krishnan S. Ramanujan, MD et al ASA Monitor February 2022, Vol. 86, 26. Medical professionalism is an evolving concept that reflects the myriad changes occurring in our health care system. In 2002, the American Board of Internal Medicine Foundation defined this concept in its physician charter, stating that medical professionalism “supports physicians’ efforts to […]
Read MoreAuthors: Matthew B. Allen, MD and Nicholas Sadovnikoff, MD, FCCM, HEC-C ASA Monitor February 2022, Vol. 86, 23–24. ASA guidelines for perioperative management of do-not-resuscitate (DNR) orders recommend that we revisit existing DNR orders prior to surgery and modify them as needed to align with patient preferences and clinical circumstances (asamonitor.pub/3lq2jgi). This “revisit and revise” or […]
Read MoreASA Monitor February 2022, Vol. 86, 14. New medical technology designed to better manage hypotension during surgery gains FDA clearance Directed Systems Limited, a medical software and data science company based in Cambridge, U.K., recently received U.S. Food and Drug Administration 510(k) clearance for a new version of its Hypotension Decision Assist (HDA) software, HDA-OR2. This […]
Read MoreAuthors: Rune P. Hasselager, M.D. et al Anesthesiology March 2022, Vol. 136, 459–471. Background Surgery is the main curative treatment for colorectal cancer. Yet the immunologic and humoral response to surgery may facilitate progression of micro-metastases. It has been suggested that epidural analgesia preserves immune competency and prevents metastasis formation. Hence, the authors tested the […]
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