Module I Lecture Flashcards
In what century did scientific findings make analgesia and eventually anesthesia possible?
19th century
The modern era of surgical anesthetics is linked to what?
Inhaled Anesthetics
In 1846, the first person to publicly and successfully demonstrate surgery with the use of ether anesthesia.
William T.G. Morton (Massachusetts General Hospital “Ether Dome”)
The first of five elements of nurse anesthetist practice?
Performing a Comprehensive H&P
The second of five elements of nurse anesthetist practice?
Conduct pre-anesthesia evaluation
The third of five elements of nurse anesthetist practice?
Obtain informed consent for anesthesia
The fourth of five elements of nurse anesthetist practice?
Develop and initiate a patient-specific plan of care
The fifth of five elements of nurse anesthetist practice?
Selecting, ordering, and prescribing and administering controlled substances
The professional organization that defines anesthesiology as a discipline within the practice of medicine.
American Board of Anesthesiology
Two primary medical specialty professional societies.
- American Society of Anesthesiologists
- International Anesthesia Research Society
Two primary anesthesia scientific journals.
- Anesthesiology
- Anesthesia and Analgesia
Two primary nurse anesthesia professional societies.
- American Association of Nurse Anesthetists (AANA)
- International Federation of Nurse Anesthetists (IFNA)
Primary scientific journal of nurse anesthesia.
AANA Journal
What are authoritative statements that describes the minimum rules and responsibilities for which nurse anesthetists are accountable?
Standards
“Perform and document a thorough pre-anesthesia assessment and evluation.”
Standard I of the Standards for Nurse Anesthesia Practice (2013)
“Obtain and document informed consent for the planned anesthetic intervention from patient or legal guardian or verify it has been obtained.”
Standard II of the Standards for Nurse Anesthesia Practice (2013)
“Formulate a patient-specific plan for anesthesia care.”
Standard III of the Standards for Nurse Anesthesia Practice (2013)
“Implement and adjust the anesthesia care plan based on the patient’s physiological status. Continuously ass the patient’s response to the anesthetic, surgical intervention, or procedure. Intervene as required to maintain the patients in optimal physiologic condition.”
Standard IV of the Standards for Nurse Anesthesia Practice (2013)
“Monitor evaluate, and document patient’s physiologic condition as appropriate for the type of anesthesia and specific patient needs. When any physiological monitoring device is used, variable pitch and threshold alarms shall be on and audible. The CRNA should attend to the patient continuously until the responsibility of care has been accepted by another anesthesia professional…”
Standard V of the Standards for Nurse Anesthesia Practice (2013)
“Document pertinent anesthesia related information on the patient’s medical record in an accurate, complete, and timely manner.”
Standard VI of the Standards for Nurse Anesthesia Practice (2013)
“Evaluate the patient status and determine when its safe to transfer responsibility of care.”
Standard VII of the Standards for Nurse Anesthesia Practice (2013)
“Adhere to appropriate safety precautions as established within the practice setting to minimize the risks of fire, explosion, electrical shock, and equipment malfunction.”
Standard VIII of the Standards for Nurse Anesthesia Practice (2013)
“Verify that infection control policies and procedures for personnel and equipment exist within the practice setting.”
Standard IX of the Standards for Nurse Anesthesia Practice (2013)
“Participate in the ongoing review and evaluation of anesthesia care to assess quality and appropriateness.”
Standard X of the Standards for Nurse Anesthesia Practice (2013)
“Respect and maintain the basic right of patients.”
Standard XI of the Standards for Nurse Anesthesia Practice (2013)
The six standards of monitoring within Standard V of Nurse Anesthesia Practice:
- Oxygenation
- Ventilation
- Continuously monitor CV status via ECG (evalluate and document heart rate and BP every 5 minutes.)
- Thermoregulation
- Neuromuscular
- Positioning
Professional organization with the purpose of assuring that no patient shall be harmed by anesthesia.
Anesthesia Patient Safety Foundation (APSF)
Professional organization that distributes a quarterly newsletter that is the most widely distributed anesthesia publication in the world.
Anesthesia Patient Safety Foundation (APSF)
What is the only specialty in medicine with a foundation dedicated solely to patient safety issues?
Anesthesiology, Anesthesia Patient Safety Foundation (APSF)
What is defined as rapid and reversible drug-induced changes in behavior or perception.
Anesthesia
What is a collection of “component” changes in behavior or perception?
Anesthesia state
First of four component changes that characterize the anesthesia state.
Unconsciousness
Second of four component changes that characterize the anesthesia state.
Amnesia
Third of four component changes that characterize the anesthesia state.
Immobility (Areflexia)
Fourth component changes that characterize the anesthesia state.
Attentuation of autonomic response to noxious stimuli
Level of sedation where patient is able to respond normally to verbal commands. Able to protect airway and maintain BP.
Minimal sedation “anxiolysis.”
Level of sedation where patient is able to respond purposefully to verbal commands and light touch. Able to protect airway and maintain BP.
Moderate sedation/analgesia “conscious sedation”
Level of sedation where patient is able to respond purposefully to repeated or painful stimuli. At risk for respiratory depression and cardiovacular collapse.
Deep sedation/ analgesia
Level of sedation where patient is unaraousable to painful stimuli or “reflex withdrawal.” At risk for respiratory depression and cardiovacular collapse.
General Anesthesia
What is the integration of the best research evidence with clinical expertise and patient values to make clinical decisions.
Evidence-based care
What is the most important reason for practicing evidence-based care (EBC)?
Enhance the probability of a good outcome in a given patient
What is a set of beliefs that are widely embraced without being questioned or doubted.
Dogma
Evidence suggests that the anesthesia provider is a _____ in infectious disease transmission
Major vector
Four interventions to reduce the anesthesia providers risk of transmitting infectious disease
- Hand hygiene
- Clean anesthesia workstation during cases
- Clean anesthesia workstation between cases
- Timely administration of antibiotics
How soon is the anesthesia provider supposed to administer antibiotics?
Within an hour of incision
