AANA journal
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Certified Registered Nurses Anesthetists (CRNAs) are airway experts who can stabilize the condition of trauma patients with skills acquired from practice as an anesthetist. CRNAs practice in a variety of settings; one of the most challenging is the rural hospital. Anesthetists have a wide range of skills. ⋯ The 13-item Airway Management and Trauma Stabilization Practice Pattern Questionnaire performed reliably (alpha = .8320). Results revealed the majority of CRNAs working in rural and semirural settings manage airways and stabilize the condition of trauma patients. Practice patterns suggest that nurse anesthesia students be trained to manage airways and stabilize trauma, particularly if they plan to work in rural or semirural settings.
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Ambulatory surgery centers (ASCs) provide surgical care for patients not requiring hospital admission for their postoperative care. Obstructive sleep apnea syndrome (OSAS) is a disease process affecting every phase of anesthesia care delivery. The potential complications of OSAS and anesthesia care have been well documented in the preoperative, intraoperative and postoperative phases. ⋯ The influence of residual anesthetics, analgesia, airway edema, and disruption of sleep cycles may result in significant postoperative apneic events in this patient population. There is a lack of studies regarding the outcomes and management of patients with OSAS in the outpatient and ASC environments. Until there are more studies defining the risk and outlining safe and appropriate care for these patients, it would seem reasonable to remain conservative in our approach because the negative outcomes in this population can be catastrophic.
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Documentation is the last component of anesthesia patient management to be affected by technology. Anesthesia information management systems (AIMS) have been introduced in a limited number of practice sites. ⋯ This results in improved patient care and possible medical legal advantages. AIMS also allow anesthesia departments to monitor their business related activity.
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Multiple sclerosis is the most common demyelinating, chronic disease of the central nervous system diagnosed in and affecting young adults. This disease can significantly alter the life of affected people, and there is no known cure. ⋯ The purpose of this AANA Journal course is to present an overview of multiple sclerosis. The pathophysiologic features, symptoms, manifestations, diagnosis, and pharmacologic treatment are discussed, with a focus on the implications of multiple sclerosis for general and regional anesthesia.