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AANA J [journal]
- Response. [Comment, Letter]
- AANA J 2014 Feb; 82(1):9.
- Pulseless electrical activity. [Comment, Letter]
- AANA J 2014 Feb; 82(1):8-9.
- Forced-air warming design. [Comment, Letter]
- AANA J 2014 Feb; 82(1):7-8.
- Can dexamethasone reduce postdural puncture headache? [Letter]
- AANA J 2014 Feb; 82(1):7.
- Like a slippery fish, a little slime is a good thing: the glycocalyx revealed. [Journal Article, Review]
- AANA J 2013 Dec; 81(6):473-80.
The glycocalyx is a dynamic network of multiple membrane-bound complexes lining the vascular endothelium. Its role in maintaining vascular homeostasis includes regulating vascular permeability as well as a range of vital functions, such as mechanotransduction, hemostasis, modulation of inflammatory processes, and serving as an antiatherogenic. Revisionist thinking about the Starling principle is discussed in terms of the major influence of the glycocalyx on capillary and tissue fluid homeostasis. The clinical and pathophysiologic threats to the glycocalyx are reviewed as well as strategies to maintain its integrity.
- Emotional intelligence as a noncognitive factor in student registered nurse anesthetists. [Journal Article]
- AANA J 2013 Dec; 81(6):465-72.
Current nurse anesthesia program admissions requirements usually focus on high grade point averages, Graduate Record Examination scores, number of years of acute care experience, and a personal interview to assist in predicting those who will succeed in these intensive academic and clinical programs. Some people believe these criteria may not be sufficient in predicting success and have suggested that the use of noncognitive criteria such as emotional intelligence measurements may be helpful. The purpose of this cross-sectional correlational study was to explore the relationship between emotional intelligence and academic factors of student registered nurse anesthetists at 3 points in a program--matriculation, at 1 year of study, and in the last semester of study--and the relationship of these to clinical scores and National Certification Examination scores. An ex post facto cross-sectional study design was used to gather data at 3 critical times in nurse anesthesia programs to explore the relationships between emotional intelligence scores, preadmission demographics, clinical scores, and National Certification Examination scores. The online Mayer-Salovey-Caruso Emotional Intelligence Test instrument provided 15 individual emotional intelligence scores for each subject. The statistical relationship between variables was examined.
- Pulseless electrical activity in a pediatric patient: a case report and review of causative factors and treatment. [Case Reports, Journal Article, Review]
- AANA J 2013 Dec; 81(6):459-64.
Pulseless electrical activity, an arrhythmia that leads to cardiac arrest, is defined as the presence of organized electrical activity without a palpable pulse or arterial blood pressure. When this arrhythmia presents during anesthesia, it has become routine practice to initiate advanced cardiac life support according to the American Heart Association guidelines. This arrhythmia is usually associated with a poor prognosis unless a reversible cause is investigated and treated immediately. The purpose of this article is to summarize the causative factors of pulseless electrical activity and its treatment modalities. This case report describes the successful resuscitation of a pediatric patient who presented with pulseless electrical activity during anesthesia for a rigid bronchoscopy.
- An evidence-based review of the use of a combat gauze (QuikClot) for hemorrhage control. [Journal Article, Review]
- AANA J 2013 Dec; 81(6):453-8.
Trauma is a leading cause of morbidity and mortality. Uncontrolled hemorrhage related to the traumatic event is often the major cause of complications and death. The use of hemostatic agents may be one of the easiest and most effective methods of treating hemorrhage. The US military recommends a hemostatic combat gauze (QuikClot Combat Gauze) as the first-line hemostatic agent for use in treatment of severe hemorrhage. This review provides essential information for evidence-based use of this agent. The PICO (patient, intervention, comparison, outcome) question guiding this search for evidence was: Is QuikClot Combat Gauze, a hemostatic agent, effective and safe in controlling hemorrhage in trauma patients in the prehospital setting? The evidence appraised was a combination of lower-level human and animal research. It did not conclusively demonstrate that this combat gauze is an effective hemostatic agent for use in trauma patients, but the results are promising in supporting its use. The evidence does not describe serious side effects, exothermic reaction, and thromboemboli formation associated with other hemostatic agents. Further investigation to determine the effectiveness of hemostatic agents, specifically QuikClot Combat Gauze, in the management of trauma casualties in the prehospital setting is required. These should include large-scale, multicenter, prehospital randomized controlled trials.
- Preoperative forced-air warming combined with intraoperative warming versus intraoperative warming alone in the prevention of hypothermia during gynecologic surgery. [Clinical Trial, Journal Article]
- AANA J 2013 Dec; 81(6):446-51.
Hypothermia in the perioperative setting can have serious consequences, including increased risk of infection or adverse cardiac events. Forced-air warming units commonly are used to prevent hypothermia. This study examined the impact of adding preoperative warming (Bair Paws, 3M) to conventional intraoperative forced-air warming modalities. Thirty patients received both preoperative and intraoperative forced-air warming, and 30 patients received intraoperative warming alone. Temperature readings were recorded across 3 time periods: preoperative, intraoperative, and postoperative. Data were analyzed using descriptive statistics, analysis of variance (ANOVA), and repeated-measures ANOVA. Demographics were similar in both groups with respect to age, body mass index, total intravenous fluids, and estimated blood loss. Statistically significant differences in temperature were seen over time (df = 2, P < .001), and for each intervention across all 3 time periods (P = .042). However, no statistically significant differences in temperature were demonstrated between groups over time. ASA status and type of procedure (laparoscopic vs open) also had no impact on results. These results suggest that preoperative warming with the Bair Paws gown offers no benefit over conventional therapy in maintaining normothermia in the perioperative period.
- Delayed onset of suspected malignant hyperthermia during sevoflurane anesthesia in an Afghan trauma patient: a case report. [Case Reports, Journal Article]
- AANA J 2013 Dec; 81(6):441-5.
Malignant hyperthermia (MH) is a rare pathologic hypermetabolic pharmacogenetic disorder of skeletal muscle calcium regulation following exposure to depolarizing muscle relaxants and/or volatile anesthetics. Although its pathogenesis is relatively well understood, there is wide variability in both the time of onset and the presentation of clinical signs and symptoms. In some circumstances the delayed onset of the hypermetabolic state may hinder timely recognition and treatment. Differential diagnosis of an MH crisis can be particularly challenging in a trauma patient, especially in an austere environment. This case report describes the presentation and management of a suspected case of MH in an Afghan national who underwent surgery following lower extremity trauma resulting from an improvised explosive device.