Week 1 Flashcards
When were anesthetic gases discovered and who primarily used them
Discovered in 1700’s
Upper middle class used recreationally
Medical students used also
Dentists in Connecticut that pioneered use of anesthesia in dentistry
Horace Wells
William Morton
Surgeon that used diethyl ether to remove cyst.
Did not document so did not get credit.
Crawford long. 1842
Demonstration of the use of ether in Ether Dome in Massachusetts General Hospital by which physician and when
William Morton
Oct 16, 1846
What is Letheon?
William Morton added red dye to ether in order to patent it and sell it
What is chloroform
Much more rapid induction than ether.
Did not cause “ether frolic”
Discovered by James Simpson
Several pt deaths after came into use
Case of Mr Meggison and Hanna Greener
Unfortunate surgeon
Unfortunate patient
Pt died very rapidly after several breaths of chloroform.
What where the main problems with anesthesia initially?
- Infection. Minimal concern for sterility.
- Physicians did not choose to specialize in anesthesiology.
- Pts did not receive continuous vigilance.
What 2 words define a nurse anesthetist
Vigilance
Integrity
First documented nurse anesthetist
Sister Mary Bernard
1877
St Vincent’s Hospital, Erie PA
Alice Magaw
“Mother of Anesthesia”
Worked at Mayo Clinic
Began to develop different type of anesthesia
Reported 14,000 anesthetics without a single complication
Agatha Hodgins
Founder of the American Association of Nurse Anesthetist.
Personal anesthetist of Dr George Crile
Introduced “gas” anesthesia: nitrous oxide/oxygen mix
Set up first school of anesthesia: Lakeside Hospital, SOA Cleveland OH
Gertrude Fife
Called for certification of anesthesia graduates
What is TEFRA?
Tax Equity and Fiscal Responsibility Act of 1982
Affect billing.
Seven conditions and anesthesiologist must satisfy to obtain reimbursement of medical direction of CRNAs
ASA Anesthesia care team statement
Believes a physician needs to be involved in each case. Not supportive of independent practice.
How many states have no requirement for physician supervision of CRNAs in their medial practice acts?
20
What are the qualifications and capabilities required for an individual to become a CRNA?
- current/unrestricted state RN license
- graduation from a nurse anesthesia program accredited by the COA
- successful completion of the certification exam by the NBCRNA
What is the COA?
Council on Accreditation of Nurse Anesthesia Education Programs
What is the NBCRNA?
National Board on Certification and Recertification of Nurse Anesthetists
What are the 3 branches of the government?
Judicial branch
Legislative branch
Executive branch
Types of law
- criminal law: body of law established to protect society from harm
- civil law: body of law concerned with private rights and remedies
What are some examples of criminal law issues?
- fraudulent insurance claims
- practicing without a license
- misuse of controlled substances
What are examples of civil law issues?
- malpractice
- torts
- intentional tort: assault, battery, false imprisionment
- unintentional tort: malpractice, negligence
Why do we have tort laws?
- to correct a wrong
- to deter certain activities from taking place
- to distribute loss
- to compensate the victim for loss or injury
- to address a social concern
- to punish or create and example
*goal is to restore the party that was has suffered damages to the condition that existed before the damage
What is negligence?
*4 things have to be proven
- Duty: consent/contract between provider and pt
- Breech of duty: practitioner did not meet the level required by law. Either an error of commission or error of omission
- Cause: show connection between negligence and injury
- Damage: must prove damages occurred
What is Res Ipsa Loquitur?
“The act speaks for itself”
No other explanation can be made. Burden of proof now on the defendant.
