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CRNA : the clinical forum for nurse anesthetists最新文献

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Essential Clinical Anesthesia Review: Management of the difficult airway 临床麻醉综述:困难气道的处理
CRNA : the clinical forum for nurse anesthetists Pub Date : 2015-01-01 DOI: 10.1017/CBO9781139584005.019
Richard Hsu, Maksim Zayaruzny
{"title":"Essential Clinical Anesthesia Review: Management of the difficult airway","authors":"Richard Hsu, Maksim Zayaruzny","doi":"10.1017/CBO9781139584005.019","DOIUrl":"https://doi.org/10.1017/CBO9781139584005.019","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/CBO9781139584005.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57118023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preemptive analgesia: its role in posterior spine surgery 先发制人镇痛:在脊柱后路手术中的作用
CRNA : the clinical forum for nurse anesthetists Pub Date : 2002-09-01 DOI: 10.1016/S1529-9430(02)00229-2
James F. Reynolds, David Verst, P. Slosar, N. Goldthwaite, M. Koestler, E. Libby, Mba Mary Nagle
{"title":"Preemptive analgesia: its role in posterior spine surgery","authors":"James F. Reynolds, David Verst, P. Slosar, N. Goldthwaite, M. Koestler, E. Libby, Mba Mary Nagle","doi":"10.1016/S1529-9430(02)00229-2","DOIUrl":"https://doi.org/10.1016/S1529-9430(02)00229-2","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"2 1","pages":"127-128"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1529-9430(02)00229-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56631857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Differential diagnosis of postdural puncture headache in the parturient. 产妇硬脊膜穿刺后头痛的鉴别诊断。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
T M Ponder
{"title":"Differential diagnosis of postdural puncture headache in the parturient.","authors":"T M Ponder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the obstetric setting, spinal and epidural analgesia/anesthesia are the 2 most frequently used forms of analgesia and anesthesia. One of the potential complications of these procedures is the postdural puncture headache (PDPH), and there is a high probability that the anesthetist will have occasion to evaluate the headache complaints of the parturient. The author reviews the differential process and discusses some of the causes and treatments of headaches in the parturient.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"145-54"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accuracy of blood loss determination by health care professionals. 卫生保健专业人员测定失血量的准确性。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
K S Kolb, T Day, W G McCall
{"title":"Accuracy of blood loss determination by health care professionals.","authors":"K S Kolb,&nbsp;T Day,&nbsp;W G McCall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients undergoing surgery will likely experience some degree of blood loss. There is much literature examining effects of blood loss, but little was found that examined accuracy of estimation of blood loss. The research question for this study was: How accurate are surgical health care professionals in their estimations of blood loss? This study was a pre-experimental between-subject design that used a convenience sample of 85 volunteers who worked in the surgical and postsurgical units of a rural southern 450-bed hospital. The participants viewed 1 of 3 randomly chosen samples of laparotomy pads with variable amounts of blood and saline. Only the researchers knew the exact amount contained on the pads. The variables that were examined and were compared included the professional group, years of experience in surgery or the postanesthesia care unit (PACU), and their estimation of blood loss. Their estimation of blood loss was compared with the actual amount of blood to determine whether one group was more accurate than another statistically and whether increasing years of experience improved accuracy. The statistical tests used were simple and multiple regressions.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"170-3"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health care delivery and change: thoughts on Lema's "... of dinosaurs, dodos and anesthesia personnel". 医疗服务和变革:对Lema“…恐龙，渡渡鸟和麻醉人员”。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
I P Gunn
{"title":"Health care delivery and change: thoughts on Lema's \"... of dinosaurs, dodos and anesthesia personnel\".","authors":"I P Gunn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Problems in health care delivery relative to access, costs, and quality have been debated for more than a quarter of a century. Health care costs have significantly increased since the implementation of the Medicare/Medicaid legislation. Cost containment has been high on the agendas of government officials, legislators, health policy decision makers, business leaders, and economists since the 1980s. There has been a shift toward market medicine and managed care as a means for cost containment. Although some costs were contained for a short period, they are once again rising significantly, and there is growing dissatisfaction with this shift. The United States is not alone in this dilemma. Mark Lema, MD, PHD, editor of the ASA Newsletter, wrote a thought-provoking editorial in the July 1999 issue, raising concerns about change, relationships, reimbursement, and demise relative to anesthesia personnel. In response, this article primarily raises the issue of health manpower mix as a major factor in the cost of health care delivery regarding these systems. Whereas change is inevitable, it is difficult for state and federal governments in the United States to force change because of the number of special interests involved in campaign financing involving elected government officials. It is nevertheless important for health professionals to be involved in the changes that come about, or change will be made for them. It is essential to renew society, institutions, and individuals in order to prevent decay and obsolescence. If we don't make the future, the future will make us.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"191-6"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meperidine utilization and compliance with Agency for Health Care Policy and Research guidelines in a tertiary care hospital. 某三级保健医院对哌替啶的使用及对卫生保健政策和研究机构指导方针的遵守情况。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
J E Pellegrini, J Paice, M Faut-Callahan
{"title":"Meperidine utilization and compliance with Agency for Health Care Policy and Research guidelines in a tertiary care hospital.","authors":"J E Pellegrini,&nbsp;J Paice,&nbsp;M Faut-Callahan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Agency for Health Care Policy and Research (AHCPR) established guidelines for the use of meperidine (demerol), a common inpatient analgesic. These guidelines define standards of care for acute and chronic cancer pain management and address many of the problems with meperidine and its metabolite, normeperidine. The purpose of this study was to determine whether meperidine was prescribed in compliance with AHCPR guidelines, whether patients exhibited any adverse reactions to meperidine, and to determine the analgesic efficacy of meperidine. Three hundred inpatient charts were reviewed and identified meperidine as the primary analgesic in 157 nonobstetric inpatients. Age, sex, weight, dosing interval, route of administration, duration of meperidine use, serum chemistry values, primary diagnosis, associated medical conditions, and medications concurrently being taken with meperidine were the parameters analyzed. An interview was conducted to ascertain medical and drug history, chronicity of pain syndromes, analgesic drug history, and analgesic efficacy. A visual analog scale for pain (range = 0 to 10) and an analgesic satisfaction survey (range = 1 to 5) were used. Of 157 patients, 124 (79.8%) were in conflict with AHCPR guidelines. The most frequent conflict was found to be suboptimal dosing regimen and treatment of chronic pain. Often concurrent analgesics were given with the meperidine to achieve adequate analgesia. Higher analgesic satisfaction scores were noted when meperidine was given with concurrent analgesics. Meperidine also was administered to patients in renal failure or with medications contraindicated with meperidine use. No significant adverse effects were noted with meperidine use in this sample population other than an increased incidence of confusion in the elderly population.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"174-80"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined spinal-epidural anesthesia/analgesia. 脊髓-硬膜外联合麻醉/镇痛。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
J D Waegerle
{"title":"Combined spinal-epidural anesthesia/analgesia.","authors":"J D Waegerle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Combined spinal epidural anesthesia offers the advantages of each method while minimizing their respective disadvantages. First described in 1937, this technique has risen in popularity over the last 15 years and is being used successfully in orthopedic, urologic, and gynecologic surgeries and for anesthesia/analgesia for labor and delivery as well as cesarean section. The history and development of combined spinal epidural anesthesia/analgesia, the different techniques, and controversies and problems associated with its use are discussed. The use of the technique of obstetric anesthesia/analgesia is also examined.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"155-64"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthetic drug interactions. Quarterly update. 麻醉药物的相互作用。每季度更新。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions. Quarterly update.","authors":"M S McAuliffe,&nbsp;E A Hartshorn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"184-90"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Placenta percreta: report of a case. percreta胎盘1例报告。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
V A Coates, M S Fishman, W G McCall
{"title":"Placenta percreta: report of a case.","authors":"V A Coates,&nbsp;M S Fishman,&nbsp;W G McCall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Placenta accreta, increta, or percreta are rare but potentially lethal obstetric emergencies. Removal of abnormal growth of the placenta into the uterine wall is difficult or impossible and results in massive blood loss. Hysterectomy may be necessary to save the mother's life. The common predisposing factors in development of placenta percreta are repeat cesarean and placenta previa. The diagnosis of placenta percreta may remain undiagnosed until delivery. The case presented describes a scenario involving placenta percreta with bladder involvement in which the diagnosis was known in advance. The article describes the preoperative preparation, intraoperative events, and postoperative status of this particular case.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"165-9"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extrauterine abdominal pregnancy: report of a case. 腹外妊娠1例报告。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1999-11-01
T Rice, C Bowser
{"title":"Extrauterine abdominal pregnancy: report of a case.","authors":"T Rice,&nbsp;C Bowser","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A healthy, 34-year-old, gravida 3, para 1,011, patient presented for cesarean delivery in her 35th week of gestation with a diagnosis of complete placenta previa. During her 26th week of gestation, the patient was admitted to a high-risk obstetric unit with the diagnosis of premature rupture of membranes. Numerous ultrasonographic studies were conducted throughout her 10-week hospital stay, confirming the admitting diagnosis. A routine cesarean section was planned, and preparations were made for a potential increase in blood loss related to the placenta previa. The procedure began under spinal anesthesia and, upon incision of the abdomen, an extrauterine pregnancy was identified. The patient was immediately anesthetized and intubated at the request of the surgeon. During the 3-hour surgical procedure, the patient sustained massive blood loss, transfusions, central line placement, and aggressive pharmacological therapy. The patient was extubated the day after surgery, and was discharged approximately 1 week later. The only major complication was compartment syndrome of the left upper extremity related to the infiltration of vasopressors requiring fasciotomy and closure 2 days later. The incidence, morbidity/mortality, and anesthetic implications of abdominal pregnancy are reviewed.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"10 4","pages":"181-3"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21575487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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