Anesthesiology Commons^™

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

Cerebral Blood Flow Measured By Diffuse Correlation Spectroscopy For Monitoring Depth Of Anesthesia In Piglets, Mert Deniz Polat, Kurtulus Izzetoglu, Randolph Sinahon, Meltem Izzetoglu, Shadi Malaeb

St. Chris Research Day

No abstract provided.

Feature Selection From Clinical Surveys Using Semantic Textual Similarity, Benjamin Warner

McKelvey School of Engineering Theses & Dissertations

Survey data collected from human subjects can contain a high number of features while having a comparatively low quantity of examples. Machine learning models that attempt to predict outcomes from survey data under these conditions can overfit and result in poor generalizability. One remedy to this issue is feature selection, which attempts to select an optimal subset of features to learn upon. A relatively unexplored source of information in the feature selection process is the usage of textual names of features, which may be semantically indicative of which features are relevant to a target outcome. The relationships between feature names …

Improving In Pacu Sign-Out Times, Manan Karki, Todd A. Glenski, Christian M. Taylor

Research Days

The post anesthesia care unit (PACU) provides specialized care to post-surgical patients recovering from anesthesia. Patients are discharged from the PACU to other clinical units or home after they are deemed stable depending on the type of surgery. A delayed discharge from the PACU can occur due to varied reasons which can affect the dynamic patient flow, have implications on pediatric population (e.g., anxiety due to parental separation), and increase the overall cost of service.

This quality improvement project looks at possible causes to PACU sign-out delays and helps develop countermeasures to improve the efficiency of signouts once patients are …

Utilizing Gastric Point-Of-Care Ultrasound Assessment For Patients With Questionable Npo Status, Carolina Botero

Doctor of Nursing Practice Projects

Perioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel …

Management Of Ineffective Epidural For Cesarean Section, Miriam Ndenecho

Doctor of Nursing Practice Projects

In the United States, epidural anesthesia is used for approximately 29-44% of cesarean sections (Carvalho, 2012). A failed or inadequate labor epidural is challenging to manage, especially when a cesarean section is imminent. A failed labor epidural is defined as insufficient pain relief within 45 min after placement, accidental dural puncture, re-siting or abandoning the procedure, and patient dissatisfaction at follow-up (Ismail et al., 2021). This project examined established best practices for managing a parturient with an ineffective labor epidural that requires a cesarean section. The literature review provided zero practice guidelines for the management of failed epidural for cesarean …

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 …

Developing An Advocacy Campaign To Minimize Barriers To Srna Political Awareness, Alejandra Villescas

Doctor of Nursing Practice Projects

Continuous advocacy and political participation have secured better working conditions and recognition of certified registered nurse anesthetists (CRNAs), translating into better patient care. This project aimed to launch an advocacy campaign targeting student registered nurse anesthetists (SRNAs). A pre-lesson survey was designed to identify SRNAs’ political participation barriers and assess their political literacy. Additionally, a lesson was developed to help SRNAs’ understand CRNA advocacy. To evaluate the educational tool, a post-lesson survey was created. These materials were distributed via email to all SRNAs (n=320) enrolled in a CRNA program in Illinois. Only 51 students completed the pre-lesson survey, and 39 …

Utilizing The Anatomage Virtual Dissection Table For Learning Neuroanatomical Structures In Nurse Anesthesia Programs, Domenica Camaci-Douleh, Nicole Gorris

Doctor of Nursing Practice Projects

Certified registered nurse anesthetists are responsible for developing expertise in neuraxial anesthesia. A thorough understanding of anatomy and physiology is essential in the performance of subarachnoid and epidural blocks. Although cadaveric dissection is considered the gold standard for learning anatomy, student use of cadavers can become limited due to supervisory, ethical, accessibility, and financial constraints (Periya and Moro, 2019). In recent years, the evolution of technology has produced a virtual option for cadaver dissection (Washmuth et al., 2020). The anatomage virtual dissection table is a tool that could be used to increase knowledge of neuroanatomical structures and their spatial relationships …

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

Stratford Campus 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 …

Adjuncts And Additives To Regional Anesthesia, Kaisi Dye, Kelcie Brunnert

Doctor of Nursing Practice Projects

With regional anesthesia becoming increasingly popular, an emphasis has been placed on choosing appropriate adjunct medications to local anesthetics for prolonging peripheral nerve blocks- lengthening postoperative pain control and decreasing perioperative narcotic usage. This project aimed to increase provider knowledge of the proven efficacy of block and adjunct selection for breast, shoulder, and knee surgeries with intended results being prolonged block duration and increased patient satisfaction post-operatively. A focused lecture along with a Likert-scale questionnaire and quiz were administered to a small sample of anesthesia providers at a rural Illinois hospital. Half (55.6%) of the providers showed evidence of knowledge …

Evaluation Of Hydrocortisone, Vitamin C, And Thiamine For The Treatment Of Septic Shock: A Randomized Controlled Trial (The Hyvits Trial), Adham Mohamed, Mohamed Abdelaty, Mohamed O. Saad, Ahmed Shible, Hassan Mitwally, Abdel-Rauof Akkari, Abdurrahmaan Elbuzidi, Awadh Bintaher, Ahmed Hashim, Marcus Lance

Anaesthesiology, East Africa

Purpose: The aim of the study is to evaluate the effect of combined hydrocortisone, vitamin C, and thiamine (triple therapy) on the mortality of patients with septic shock.

Methods: This multicenter, open-label, two-arm parallel-group, randomized controlled trial was conducted in four intensive care units in Qatar. Adult patients diagnosed with septic shock requiring norepinephrine at a rate of ≥0.1 μg/kg/min for ≥6 h were randomized to a triple therapy group or a control group. The primary outcome was in-hospital mortality at 60 days or at discharge, whichever occurred first. Secondary outcomes included time to death, change in Sequential Organ …

Implementation Of A Glidescope Educational Program For Novice Student Registered Nurse Anesthesiologists, Joshua F. Snodgrass, Brian Bendel

Doctor of Nursing Practice Projects

GlideScope Video laryngoscopy carries a higher risk of injury to the pharyngeal cavity than direct laryngoscopy. Verathon is aware of this risk and has developed a proprietary “Four-step method” to mitigate it. This project aimed to reduce injuries related to GlideScope video laryngoscopy by providing first-year nurse anesthesiologists at Southern Illinois University Edwardsville with didactic and simulation education related to GlideScope video laryngoscopy and injury prevention. Didactic education was provided via a pre-recorded PowerPoint presentation. Simulation education was provided with the GlideScope and airway trainer manikins. The participants completed an identical 8-question pre-test and post-test to assess for knowledge gain …

Diagnosis And Management Of Colon Cancer Patients Presenting In Advanced Stages Of Complications, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Anca Silvia Dumitriu, Stana Paunica, Daniela Gabriela Bălan, Bogdan Socea

Journal of Mind and Medical Sciences

Colorectal cancer is an important health problem with a significant impact on the individual and society. Malignancy (including colorectal cancer) is usually slightly symptomatic in its initial stages. This causes cancer to be discovered in some patients accidentally (either through screening tests in predisposed individuals or during routine investigations for other diseases), while in other patients the colorectal cancer is discovered in late stages, when the symptoms are much more intense due to complications. Unfortunately, such advanced cases of the disease have high rates of morbidity and mortality even with treatment. Current treatment methods are usually complex, interdisciplinary, causing significant …

Management Of Anxiety And Depression In Post Coronary Artery Bypass Graft Surgery, Mansour Jannati, Amir Aslani

Journal of Mind and Medical Sciences

Depression and anxiety are common events in 30-40 percent of post coronary artery bypass graft (CABG) surgery patients. Depression symptoms in patients with CAD are expected to be significantly more, comparing the public incidence rate. Impaired remedy after coronary artery events may partly be attributed to depression and anxiety. If anxiety continues, it may lead to elevate metabolism and oxygen consuming. High level of anxiety increases the pain sensation in post CABG patients. This paper aimed to review results and findings of previous studies in the field of anxiety and depression management of post coronary artery bypass graft surgery. Up …

Acute Lithiasis Cholecystitis; Particularities Of Diagnosis And Treatment In The Elderly, Adrian Silaghi, Bogdan Socea, Petrisor Banu, Vlad Dumitru Baleanu, Dragos Epistatu, Ioana Paunica, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Objectives. The incidence of acute cholecystitis increases with age, when patients usually associate additional comorbidities. Such comorbidities and the late presentation to the doctor make the treatment more complex, associating higher rates of complications. The present study aims to evaluate the methods of diagnosis and treatment applied to a group of older patients with acute cholecystitis. Materials and Methods. 585 patients were enrolled in the study between 2019 and 2023. The inclusion criteria in the study were represented by the presence of the diagnosis of acute cholecystitis in patients over 65 years of age, while patients who presented complex locoregional …

Tips And Tricks For Laparoscopic Cholecystectomy In The Patient With Ventriculoperitoneal Shunt; A Case Report, Carmen Popa, Andrei Moisin, Mihai Faur, Mihaela Racheriu, Ramona Coca, Cristian Mihai Branescu, Tiberiu Trotea, Denisa Tănăsescu

Journal of Mind and Medical Sciences

Laparoscopic surgery in patients with ventriculo-peritoneal shunt is challenging in terms of technical approach. The severity of possible complications and the lack of studies on this association increase the surgeon's discomfort with such surgery. The main complications that may occur are increased intracranial pressure, secondary pneumo-peritoneum pneumocephalus, encephalitis and the risk of catheter injury during laparoscopic procedures. We present the case of a 56-year-old patient operated in 2004 for a basilar artery top aneurysm with subarachnoid hemorrhage and secondary hydrocephalus, for which a ventriculo-peritoneal shunt was fitted. This patient presented in our clinic with diffuse abdominal pain, more accentuated in …

The Practice Environment For Nurse Anesthetists In Tennessee, Taylor Cathey, Jessica Hobbs, Matthew Owen, Alexis Varney, James Alberding, Tausha Alexander

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

Potential consequences of anesthesia provider shortages may include a reduction in health care access, poor patient outcomes, and increased costs to government funded agencies. Current leaders in the anesthesia profession need to establish a work environment that is embracing, supportive, and safe so that certified registered nurse anesthetists (CRNA) can remain healthy and productive. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to provide an overview of the current CRNA practice environment in Tennessee and advocate for policies to promote CRNA retention and enhance patient access to care. The overarching goal included gathering sufficient evidence regarding …

Evidence-Based Practice Guidelines For The Optimal Assessment Of The Airway In Predicting Difficult Intubation, Meredith Louden

Doctor of Nursing Practice Scholarly Projects

Adverse respiratory events are the most common injuries in anesthesia; difficult intubation and ventilation contribute to most cases. Injuries following inadequate airway management include cerebral hypoxia, aspiration, and cardiac arrest. Despite the risk and consequences following inadequate airway management, most medical facilities lack standardized airway assessments for anesthesia providers. Current evidence implicates that ultrasound measurement of the hyomental distance demonstrates the highest specificity and accuracy in predicting difficult intubation. The traditional approach to conducting airway assessments includes Mallampati classification, which shows high specificity for predicting difficult airways only when combined with other airway assessments. The purpose of this evidence-based project …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …