Editor's Note Targeting a patient’s mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) by monitoring cerebral blood flow autoregulation may reduce the incidence of delirium after cardiac surgery in older patients, this Johns Hopkins study finds. In this analysis of 199 patients, the incidence of delirium was significantly greater in…

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Editor's Note No bacterial growth was found in any of 257 samples of normal saline and dextrose 5% in water (D5W) 24 hours after using standard sterile techniques to spike them in the perioperative area. Two 1000 mL bags of IV normal saline and D5W were spiked and hung in…

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Editor's Note Education and monitoring of hand hygiene among anesthesia providers in the OR improved hand hygiene compliance in this study from the Duke University School of Nursing, Durham, North Carolina. Anesthesia providers were educated on the World Health Organization’s five indications for hand hygiene, and their access to hand…

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Editor's Note Educating anesthesia providers on the World Health Organization’s five indications for hand hygiene, increasing access to hand hygiene products in the OR, and monitoring  hand hygiene among anesthesia providers can improve hand hygiene compliance, this study finds. Hand hygiene was observed in three phases: Preimplementation, postimplementation, and 60…

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Editor's Note Failure to debrief after critical events is common in anesthesia trainees and teams, and communication breakdowns are associated with the failure to debrief, this study finds. Over a 1-year period at a large academic medical center, anesthesiology residents and some attending anesthesiologists were audited and/or interviewed about the…

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An estimated 22 million people in the US have obstructive sleep apnea (OSA), but up to 80% of cases are undiagnosed, and some 30% to 40% of the surgical population has diagnosed or suspected sleep apnea. More than 3 years ago, the Joint Commission issued a Quick Safety document about…

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Editor's Note The Society for Healthcare Epidemiology of America (SHEA) on December 11 published a new expert guidance on “Infection prevention in the operating room anesthesia work area.” Key recommendations of the guidance to improve infection prevention include: Increased hand hygiene performed, at a minimum, before aseptic tasks, after removing…

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Editor's Note The Perioperative Surgical Home (PSH) model of care was successful in improving quality of care and outcomes in elderly hip fracture patients and children having cardiac surgery in two studies presented October 14 at the Anesthesiology 2018 annual meeting in San Francisco. One study compared 308 hip fracture…

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Editor's Note In this study, the composition of the anesthesia care team (anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was not associated with any significant differences in mortality, length of stay, or inpatient spending. Of 443,098 Medicare beneficiaries who had inpatient surgery between 2004 and 2011, the adjusted mortality for…

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Editor's Note The Society of Anesthesia and Sleep Medicine (SASM) has issued a new guideline on Intraoperative Management of Adult Patients with Obstructive Sleep Apnea (OSA). Specific aims of the guideline are to: evaluate considerations of difficult airway management in patients with OSA assess the impact of anesthesia-related drugs and…

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