AANA journal
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Pulmonary aspiration of gastric contents during anesthesia is a complication that is fortunately rare, yet potentially catastrophic. Despite its infrequency, techniques geared toward preventing this serious outcome influence many of our routine practices and beliefs. ⋯ This AANA Journal course outlines current knowledge as to the incidence, risk factors, and efficacy of practices geared toward preventing aspiration. It is anticipated that this review will stimulate discussions regarding possible changes in the anesthetic management of patients in individual practice settings.
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The American Society of Anesthesiologists (ASA) Physical Status (PS) Classification is used worldwide by anesthesia providers as an assessment of the preoperative physical health of patients. This score also has been used in policy-making, performance evaluation, resource allocation, and reimbursement of anesthesia services and frequently is cited in clinical research. The purpose of this study was to assess interrater reliability and describe sources of variability among anesthesia providers in assigning ASA PS scores. ⋯ There were no significant differences between the anesthesia provider groups. There was no correlation between ASA PS scoring and years practicing or any of the other demographic variables. Several sources of variability were identified: smoking, pregnancy, nature of the surgery, potential difficult airway, and acute injury.
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The laryngeal mask airway has become one of the major tools of modern anesthesia airway management. Despite the fact that no time limit has been recommended regarding its safe use in spontaneously breathing children, or adults, there is still reluctance to use the laryngeal mask airway in operations of long duration. We report the case of an uneventful 5-hour long laryngeal mask anesthesia in a spontaneously breathing 11-year-old boy undergoing lower limb surgery.
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Children's responses to parental presence during anesthetic induction have been researched thoroughly; however, not much is known about the response of parents to being present at their child's induction. The purpose of this research was to examine parent's preparation for, attitudes and emotions about, and experiences with being present for their child's anesthetic induction. Participants included parents who accompanied their children ranging from 1 to 10 years of age during induction by general anesthesia. ⋯ They thought their presence was beneficial to their child, themselves, and anesthesia personnel. Overall satisfaction with preparation was related to the completeness of the information they received (r = 0.35; P < .04). Complete and accurate information about the induction event before surgery and emotional support during induction are important psychosocial aspects of anesthesia care for parents who plan to be present during their child's induction.