Anesthesia and Analgesia Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Do Nsaids' Decrease Union Rates Following Joint Arthrodesis? A Meta-Analysis, Emerson Rowe, Julian Takagi-Stewart, Asif Ilyas, Sina Ramtin

Tower Health Research Day

No abstract provided.

Thermoregulation In Colorectal Patients: Heating Co2 Insufflation Gas, Alejandro Conde, Alieu Jawara, Laura Savage, James Alberding Dnp, Michael Godbold

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: 600,000 colorectal surgeries are performed annually in the United States, with 26-90% experiencing some form of unintended hypothermia. Consequences of hypothermia include surgical site infections (SSIs), delayed wound healing, cardiac dysrhythmias, and increased hospital length of stay. Utilization of the laparoscopic approach to intra-abdominal colorectal surgery uses un-warmed CO₂ gas. Multiple studies demonstrate the addition of heated CO₂, for insufflation, reduces intraoperative hypothermia.

LOCAL PROBLEM: This project was implemented at a facility in Tennessee. On average, 250 laparoscopic colorectal cases are performed at this facility annually. Participants were adult colorectal surgical patients, 18 years …

Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).

LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.

METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …

Implementation Of A Single-Patient-Use Airway Taping Product In The Operating Room, Savannah Sierra Nicole Craig, Kaitlin D. Burrell, Jennifer Patrick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Anesthesia providers use adhesive tape to secure advanced airway devices. Rolls of adhesive tape serve as reservoirs for pathogens. Rolls of tape do not have instructions on how they are to be reused, cannot be disinfected, and should not be repurposed. The re-use of rolls of tape poses a risk to patient safety.

LOCAL PROBLEM: The project facility was an academic medical center in the Southeast region of the United States. The facility does not have taping practice guidelines in place. Rolls of tape are handled without gloves, used by several providers, placed on multiple patients’ faces, and stored …

An Objective Structured Clinical Examination (Osce) For Pec-Ii And Intrapec Block For Breast Augmentation Surgery, Kaleb Smith

Doctoral Projects

Ultrasound-guided regional anesthesia techniques are valuable tools for anesthesia providers to learn and implement in their practice. Two specific blocks that student registered nurse anesthetists (SRNAs) need to utilize are PECS-II and the Intrapec block for reconstructive breast augmentation and mastectomies. Teaching these blocks to SRNAs in the clinical setting may be difficult as they will be under higher pressure to perform since they will be practicing on live patients. Understanding this stress led to a review of the current Nurse Anesthesia Program (NAP) curriculum at The University of Southern Mississippi (USM) and found a gap in the education, which …

Submental Intubation In Oral Maxillofacial Surgery: A Case Report And Review Of Indications And Complications, Ed W. Alvarado, Jennifer Inofomoh, Mark Lavering, Diego Aleman

MEDI 9331 Scholarly Activities Clinical Years

Background: Submental intubation has emerged as a crucial alternative airway management technique within the realm of oral maxillofacial surgery, addressing scenarios where conventional intraoral or nasal intubation proves infeasible or hazardous. The landscape of oral maxillofacial surgeries is characterized by intricate fractures, extensive soft tissue damage, and anatomical deviations that render traditional intubation methods untenable. This innovative technique involves the insertion of a modified oral endotracheal tube through a submental incision, subsequently threading it into the oropharynx. This procedure ensures secure airway access while safeguarding the integrity of oral and nasal passages. This modality reaps manifold benefits, spanning augmented …

Stellate Ganglion Block For Refractory Raynaud’S Phenomenon- A Case Report, William J. Naber Ii, Derik J. Scribner, Gabriel Howard

Graduate Medical Education Research Journal

Introduction: Raynaud’s phenomenon (RP) is predominately a sympathetically mediated ischemic vasospastic disease involving the distal limbs and is associated with sharp pains, numbness, and dermatological color changes. The symptoms are commonly induced by cold weather, stress, and trauma and it is known to affect 4.85% of the population. There are few well-defined treatments for patients with RP that are refractory to 1st-line therapies. We present a case of intractable RP with corresponding response to stellate ganglion block (SGB) which demonstrates the efficacy profile and safety of SNS blocks in treatment of resistant RP.

Methods: Per Bon Secours Mercy Health …

Noninvasive Continuous Monitoring To Improve Outcome Of Preeclamptic Women Undergoing Spinal Anesthesia For Cesarean Section, Andrea M. Regan, Molly Amin, Josue Brainin Md

Department of Health Sciences Faculty Proceedings, Presentations, Posters, Speeches, Lectures, etc.

Spinal induced hypotension is a common side effect and occurs in up to 33% of patients. Preeclamptic women have a high risk of severe hypotension related to spinal anesthesia while undergoing cesarean section Hypotension, short or cumulative episodes, increase nausea and vomiting in parturient and can potentially result in fetal acidosis, hypoxic-ischemic encephalopathy(HIE), and lower Apgar scores. The recommend standard of care is a minimum of five-minute interval blood pressure monitoring which risks late detection and treatment of hypotension. ClearSight® noninvasive continuous hemodynamic monitoring decreases the risk of hypotension-associated complications in mother and fetus and improves maternal nausea and vomiting …

Obstetric Treatment Of Post Dural Puncture Headaches (Pdph): Less Invasive Alternatives To Epidural Blood Patches (Ebp), Andrea M. Regan, Molly Amin, Josue Brainin Md, Sanjeev Patel Md

Department of Health Sciences Faculty Proceedings, Presentations, Posters, Speeches, Lectures, etc.

Neuraxial labor analgesia for vaginal delivery or cesarean section is performed in more than 71% of women in the United States. Postdural puncture headache(PDPH) is a relatively common complication of neuraxial anesthesia. Epidural blood patch (EBP) is considered the gold standard treatment, and although EBP is a highly effective intervention, it is not without risk. There is growing evidence that less invasive alternative treatments, such as combined use of atropine and neostigmine have effectively relieved PDPH where traditional, conservative methods have failed. The goal is to discover the best method in preventing PDPH and less invasive treatment alternatives compared to …

Development Of A Nurse Anesthesia Program Point-Of-Care Ultrasound Airway Examination Curriculum, Sarah Elyse Sandheinrich Butler, Colton Phillip Butler

Doctor of Nursing Practice Projects

Airway management is a critical and fundamental skill for anesthesia providers. Point-of-care ultrasound (POCUS) is an up-and-coming assessment technique that can provide critical information about a patient’s airway anatomy and may increase patient safety during anesthesia care. As a result, understanding the appropriate POCUS equipment, techniques, findings, and clinical implications for airway examination can become essential for safe and effective anesthesia practice. This project aimed to develop a clinical airway POCUS examination curriculum with detailed instructions on all aspects of appropriate examination equipment, set-up, technique, and implications for findings. The team designed the curriculum to incorporate it into the host …

Comparison Between Honey Produced By Bees, Aphids And Wasps In Kurdistan Region - Iraq Based On Biochemical Parameters, Jian Lateif Hussein

Al-Bahir Journal for Engineering and Pure Sciences

Honey is a sweet substance that has been valued by humans for its taste and health benefits. It is produced by honey bees from the sugary secretions of plants. However, other insects, such as aphids and wasps, also produce honey-like substances. This study aimed to compare the physical and biochemical properties of honey produced by honey bees, aphids, and wasps in the Kurdistan Region of Iraq. To achieve this, samples of honey, bitter honey, honeydew, and wasp honey were collected and examined. The samples were analyzed for total sugar, sucrose, water, Hydroxymethylfurfural (HMF), acidity, total acidity, diastase activity, total phenolic …

Standardization Of Perioperative Management Of The Breastfeeding Women, Amrutha Panakkal

Doctor of Nursing Practice Projects

Mother's milk is the optimal nutrition for the term and preterm neonates. The psychological and physiological stressors in the perioperative setting can impede a lactating mother's ability to breastfeed in the postoperative setting successfully. A best-practice guideline incorporating a stoplight color-coding chart and categories such as "safe," "caution," and "consider avoidance" was used to group medications according to their safety for anesthesia providers in a large urban academic medical center in Pennsylvania. The evidence-based guideline also provided links to the hospital policy, LactMed, and Hale database to streamline resources and aid in the rapid decision-making of anesthesia providers in identifying …

Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse

Doctor of Nursing Practice Projects

Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students

Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA

Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

The Efficacy Of Osteopathic Manipulative Treatment In Reducing Pain Medication Usage In Chronic Pain Patients: A Brief Literature Review, Catherine Alapatt, Kinjal Shah

Rowan-Virtua Research Day

Chronic pain is one of the most common complaints for adult patients. Chronic pain almost always includes a pharmacological approach which can involve opioids and non opioids. Non-pharmacological approaches are less commonly used by patients with chronic pain, despite the significant misuse of opioids in the treatment of chronic pain. There is a need for nonpharmacological therapies in the treatment of chronic pain patients to lessen the misuse of opioids. One underused form of nonpharmacological therapy for chronic pain is OMT. There have been several studies demonstrating OMT to be effective in treating chronic pain conditions. In addition, there is …

Chemical Restraints In The Emergency Department, Nicholas Noffsinger

Rowan-Virtua Research Day

Chemical restraint is a critical intervention used in emergency departments to manage acutely agitated or violent patients. It involves the administration of medication to induce sedation and control behavior, with the goal of ensuring patient and staff safety while allowing necessary medical interventions to be performed. However, the use of chemical restraints necessitates close observation of vital signs and any potential side effects, as well as careful consideration of patient-specific considerations.

Three-Dimensional Evaluation Of The Mandibular Lingula On Cone-Beam Computed Tomographic Images In The Turkish Population, Zerrin Unal Erzurumlu, Damla Torul

Journal of Dentistry Indonesia

Objective: The purpose of this study was to provide morphometric and anatomical data for mandibular lingula (Li) in The Turkish population using three dimensional-cone beam computed tomography (3D-CBCT) images. Methods: CBCT images of the patients taken between July 2020 and March 2021, were retrieved from the archival records. A total of 100 Li’s of 50 patients who met the criteria of this study were evaluated. The distances between the tip of the Li and ramal landmarks/occlusal plane were measured and the shape of the Li was evaluated on 3D-CBCT images. Results: CBCT images of the 50 patients (19 males and …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

Improving Patient Outcomes One Warm Patient At A Time, Lindsey King, Marcus Austin Robison, Julie Bonom Dnp, Michael Godbold Md

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Patient Temperature measurement postoperatively reveals that hypothermia occurs in surgical patients 25-90% of the time. Unintended perioperative hypothermia can be linked to many negative patient outcomes such as increased incidence of surgical site infection (SSI), delayed wound healing and increased length of hospital stay, to mention a few. Any single or combination of the aforementioned issues can eventually lead to an increase in patient morbidity and mortality. The purpose of this proposed quality practice improvement project is to increase the compliance of hypothermia prevention strategies, specifically forced air warming, at the implementation site. The targeted practice improvement is aimed at …