A landmark Canadian lawsuit occurred this year for a case of intraoperative awareness with the title:

"Woman who felt surgeons ‘rip her apart’ wins Canada’s first malpractice ruling over waking during operation"
...

American Society of Anesthesiologist (ASA) President Dr. Jeff Plagenhoef recently sent out an email to all members of the ASA imploring them to fill out a SURVEY comparing Certified Registered Nurse Anesthetist (CRNAs) and Anesthesiologist Assistants (AAs) when under medical direction.
...

CRNAs: A short history of nurse anesthesia and the future of anesthesia care.

What's old is new again. I have always had a keen interest in anesthesia history and as a resident in anesthesia, presented some articles and papers for the International Anesthesia History Association on Chauncey Leake and the development of divinyl ether and at the Anesthesia History Association here in the US on Sir William Macewen and early attempts at intubating patients under general anesthesia. I am a firm believer, as a scientist, clinician and physician leader, that one must truly ...

Physicians Assistants asociation (AAPA) has posted a video by Ron Byerly, PA-C talking about dissolving the required relationship between PAs ...

Mary Frances Mullins DNP CRNA graduated in June 2016 from Grand Canyon University with her Doctor of Nursing Practice (DNP) degree. In 2001, she graduated from the Uniformed Services University in Bethesda with an MSN in nurse anesthesia. She also holds CPAN and CAPA certification and currently works at Memorial Medical Center in Modesto, CA

Preoperative Screening for Obstructive Sleep Apnea: Enhancing Perioperative Safety

Abstract
Nearly 25 million people in the United States suffer from obstructive sleep apnea (OSA). This serious under-recognized, under-diagnosed medical disorder is associated with significant comorbidities as well as increased perioperative risks. Therefore, preoperative screening for OSA using a validated OSA screening tool such as the STOP-Bang OSA screening questionnaire is imperative. Using a quantitative methodology with a comparative design, this author observed for statistically significant differences in the proportion of postoperative hypoxemia between two sample groups. Group A (n=100) was comprised of adult (ages 18-75) general anesthesia elective surgery patients who were screened preoperatively for OSA on the STOP-Bang OSA screening instrument. Group B (n=100) was comprised of adult (ages 18-75) general anesthesia elective surgery patients who were not screened preoperatively for OSA on the STOP-Bang OSA screening instrument. A Chi-square analysis was conducted comparing the proportion of positive postoperative hypoxemia occurrences in the Post Anesthesia Care Unit (PACU). The proportion of patients who experienced hypoxemia in the PACU pre implementation of the STOP-Bang screening program was not equal to the proportion of patients who experienced hypoxemia in the PACU post implementation of the program, χ² (1, N = 94) = 2.085, p = .149. This was statistically nonsignificant, but clinically relevant. Clinician awareness of the potential existence of OSA can guide the perioperative care plan to safely meet the special needs of surgical patients with OSA.


Table of Contents
List of Tables. ix
List of Figures. x
Chapter 1: Introduction to the Project 1
Background of the Project 2
Problem Statement 4
Purpose of the Project 5
Clinical Question. 6
Advancing Scientific Knowledge. 6
Significance of the Project 7
Rationale for Methodology. 9
Nature of the Project Design. 9
Definition of Terms. 10
Assumptions, Limitations, and Delimitations. 13
Summary and Organization of the Remainder of the Project 15
Chapter 2: Literature Review.. 18
Background. 20
Conceptual Framework for Implementing Preoperative STOP-Bang OSA Screening: The Iowa Model 22
Literature Review.. 25
Obstructive Sleep Apnea: Pathogenesis and Comorbidities. 25
Obstructive Sleep Apnea: Cardinal Features. 27
Treatment of Obstructive Sleep Apnea. 27
Obstructive Sleep Apnea: Preoperative Diagnosis. 30
Obstructive Sleep Apnea Associated Perioperative Complications. 36
Perioperative Management of Patients with Obstructive Sleep Apnea. 45
Healthcare Professional Attitudes on Perioperative Care of Patients with OSA.. 46
Summary. 47
Chapter 3: Methodology. 51
Project Methodology. 52
Project Design. 53
Population and Sample Selection. 55
Instrumentation. 55
Validity. 57
Reliability. 58
Data Collection Procedures. 59
Data Analysis Procedures. 60
Ethical Considerations. 61
Limitations. 62
Summary. 63
Chapter 4: Data Analysis and Results. 66
Descriptive Data. 67
Data Analysis Procedures. 70
Results. 70
Summary. 77
Chapter 5: Summary, Conclusions, and Recommendations. 79
Summary of the Project 81
Summary of Findings and Conclusions. 82
Practical, Future, and Theoretical Implications. 85
Recommendations for Future Projects. 86
Recommendations for Future Practice. 87
Conclusion. 88
References. 90
Appendix A.. 107
Appendix B.. 108
Appendix C.. 109
Appendix D.. 111
Appendix E. 112



List of Tables

Table 1. Descriptive Statistics of Demographic Variables.................................................. 70
Table 2. Pearson Chi-Square Goodness of Fit Between Implementation of the STOP-Bang Screening Program and Proportion of Patients who Experience Hypoxemia in the PACU................ 73

List of Figures

Figure 1. STOP-Bang Questionnaire Total Score Occurrence Frequency ........................ 75
Figure 2. STOP-Bang Obstructive Sleep Apnea Level of Risk Percent ............................ 76
Figure 3. Hypoxemia Frequency Occurrence .................................................. .................. 77



Chapter 1: Introduction to the Project

Obstructive sleep apnea (OSA) is a prevalent sleep-associated breathing disorder characterized ...

Mark Giles, DNP, CRNA is a 2016 graduate of Quinnipiac University, Hamden, Connecticut, post master's program. He is a staff CRNA at Yale New haven Hospital, New Haven, Connecticut, and an adjunct faculty member at Quinnipiac University.



General Anesthesia versus Conscious Sedation for treatment of acute ischemic stroke with Intra-arterial mechanical thrombectomy: ...

This is the final submission of National University's Binju KC's Scholarly Project. She is a Nurse Anesthesia Resident at National University.



Background

The shoulder joint is the most flexible joint in the human body; therefore, it is more susceptible to injury than others.¹ Surgical interventions may sometimes be performed depending on the nature of the injury. A comprehensive analysis of the epidemiology of shoulder surgeries is beyond the scope of this report. Moreover, the variations in shoulder surgeries based on the type of injury being corrected, the facility setting, and reimbursement ...

This last week the Vice President and Executive Editor of Audio Digest, Lon Osmond sent out a letter which angered and disenfranchised 50,000 Nurse Anesthetists. The letter was an apology to Physician Anesthesiologist ...

Press Release from the AANA HERE

Introduction


Historically, in some settings, publications, policies and law, the Certified Registered Nurse Anesthetist (CRNA) has been referred to as a “midlevel provider” or “physician extender.” These and other terms are ...