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CRNA : the clinical forum for nurse anesthetists最新文献

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Anesthesia information management systems as a cost containment tool. 麻醉信息管理系统作为成本控制工具。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-05-01
R L Coleman, I C Sanderson, D A Lubarsky
{"title":"Anesthesia information management systems as a cost containment tool.","authors":"R L Coleman,&nbsp;I C Sanderson,&nbsp;D A Lubarsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anesthesia information management systems (AIMS) have uses that extend far beyond automatic anesthesia record-keeping. After initial experience with the development of monitoring technology, the Department of Anesthesiology at Duke University Medical Center, Durham, North Carolina, began the installation of the Arkive anesthesia information management system in 1987. The system was installed hospital-wide in 1992. AIMS played an integral role in determining the cost of pharmaceutical agents used during an anesthetic procedure. Clinicians targeted areas of high cost in which anesthetic practice could be modified. Establishment of an educational program followed by the institution of practice guidelines allowed for an annualized savings of more than $900,000 on drug costs with no effect on the quality of care provided. Future generations of AIMS need to be more fully integrated into hospital information management systems.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 2","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20243856","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. 麻醉药物的相互作用。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-05-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions.","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":"8 2","pages":"84-7"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20243857","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
Religious restrictions and the trauma patient. 宗教限制和创伤病人。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
L Williams
{"title":"Religious restrictions and the trauma patient.","authors":"L Williams","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article discusses some of the dilemmas the Certified Registered Nurse Anesthetist (CRNA) faces when the patient refuses potential life-saving blood products or a blood transfusion. Even if the CRNA disagrees with the patient's decision, the patient's right to refuse is taken very seriously in the legal arena. Without a court order, the patient cannot be forced to receive blood or blood products. It would be easier if there were clear guidelines; unfortunately, these do not exist. In the past, courts were more likely to agree with the anesthesia provider and order the transfusion, even if the patient were competent. Today, courts are less likely to do so in these cases. However, there are circumstances in which obtaining a court order for the transfusion is more predictable, such as if the patient is a child in a true emergency situation, or if the patient is pregnant and the fetus is viable.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 1","pages":"40-4"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20101822","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. 麻醉药物的相互作用。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions.","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":"8 1","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20101823","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
Fluid resuscitation in the trauma patient. 创伤病人的液体复苏
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
M A Conte
{"title":"Fluid resuscitation in the trauma patient.","authors":"M A Conte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fluid management of the trauma patient can be challenging to the nurse anesthetist. Often the Certified Registered Nurse Anesthetist is unaware of the total blood loss of a trauma victim (ie, how much blood loss occurred at the scene). The anesthetist must quickly assess the patient's vital signs and response to fluid replacement to effectively treat the acute blood loss. In today's healthcare market, when cost of care is consistently scrutinized, the nurse anesthetist must weigh the risks and benefits to a patient when selecting fluid therapies. This article outlines current resuscitative theories and fluid types available for use in resuscitating the trauma patient.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 1","pages":"31-9"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20103256","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
Trauma to the neck and larynx. 颈部和喉部受伤。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
M Kelly
{"title":"Trauma to the neck and larynx.","authors":"M Kelly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Trauma is the leading cause of death for persons from 8 months to 44 years of age. The precise incidence of neck trauma is unknown. Autopsy studies have shown that the majority of the individuals with a major airway injury die at the scene of the accident, as a result of asphyxia caused by interruption or obstruction of the airway, compounded by aspiration of blood and intrapulmonary hemorrhage. A neck traumatized patient thoroughly challenges the practitioner's ability to coordinate, diagnose, and rapidly formulate a proper method of treatment.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 1","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20103252","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
Anesthesia for trauma during wartime. 战时创伤麻醉。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
C R Barton, M Beeson
{"title":"Anesthesia for trauma during wartime.","authors":"C R Barton,&nbsp;M Beeson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Trauma during wartime has been the scourge of the ages. Conventional anesthesia with ether has been available since 1846 when it was demonstrated in Boston by a dentist named William Morton. Subsequently, ether was used during the Mexican-American War in 1847, and chloroform was used during the Crimean War from 1854 to 1856. Nurse anesthetists have made substantial contributions to care of the war-injured by initiating acute airway management and resuscitation efforts and by the administration of anesthesia care for critically injured war casualties undergoing surgical procedures. They have further contributed to goodwill in war-torn areas by providing anesthesia care to many civilian children and adults living in these areas of conflict. The evolution of nurse anesthesia contributions to the treatment of traumatized war casualties is the central focus of this article.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 1","pages":"2-12"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20103249","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
Trauma in the rural setting. 农村环境中的创伤。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-02-01
S Fassett, P Miles
{"title":"Trauma in the rural setting.","authors":"S Fassett,&nbsp;P Miles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article provides an overview of rural trauma, focusing on the challenges that exist for rural providers compared with those who work in urban trauma centers. The authors outline the role of a Certified Registered Nurse Anesthetist working in trauma care at rural hospitals and address responsibilities involved in this expanded role.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 1","pages":"13-21"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20103251","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
Pathophysiology of the respiratory system related to anesthesia. 与麻醉有关的呼吸系统病理生理学。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1996-11-01
C B Drain
{"title":"Pathophysiology of the respiratory system related to anesthesia.","authors":"C B Drain","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pathophysiology of the respiratory system can be viewed by simply evaluating the status of a functional residual capacity (FRC). More specifically, patients with airways that are characterized as extremely compliant or \"floppy\" will have an increased FRC, which is the hallmark of chronic obstructive pulmonary disease. Patients with noncompliant, \"stiff\" lungs suffer from a form of restrictive disease with a resultant reduction in the FRC. Hence, the implications for anesthesia care focus on the FRC; that is, raising the FRC in the restrictive disease patient and normalizing or preventing further increase in the FRC in the patient with chronic obstructive pulmonary disease.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"7 4","pages":"181-92"},"PeriodicalIF":0.0,"publicationDate":"1996-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20031338","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
Anesthesia for the pediatric patient with asthma. 小儿哮喘患者的麻醉。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1996-11-01
V L Cassani
{"title":"Anesthesia for the pediatric patient with asthma.","authors":"V L Cassani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pediatric patients present an interesting challenge for any anesthetist. Whether it is an infant born through meconium-stained fluid in the emergency department of a community hospital, or a 2-year-old who swallowed a coin, the anatomic and physiological differences of the pediatric patient affect the way that anesthetic care is planned and administered. Having a clear understanding of these underlying differences will allow the anesthesia provider to adapt to the rapidly changing and clinically divergent situations seen in this interesting patient population. This article briefly discusses the anatomic and physiological differences of pediatric patients along with the clinical applications of the patient with pediatric asthma.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"7 4","pages":"200-6"},"PeriodicalIF":0.0,"publicationDate":"1996-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20031340","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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