Anesthesia Patient Safety Podcast

Every anesthesia professional has encountered IV infiltration—but when neuromuscular blocking agents are involved, this common complication becomes a complex patient safety challenge with no established guidelines.This episode delves into the critical management of infiltrated paralytics, a complication affecting 14% of peripheral IV catheterizations that can lead to delayed induction, compromised emergence, and potentially serious tissue injury. We're joined by Dr. Govind Rangrass, Professor of Anesthesiology and Critical Care, who shares why this overlooked issue deserves urgent attention: "When a paralytic is involved, the complexity skyrockets and there's almost no literature to guide us."We break down a comprehensive management algorithm, from the counterintuitive first step of leaving the infiltrated catheter in place to attempt medication aspiration, through systemic absorption enhancement techniques using hyaluronidase and nitroglycerin paste. The episode covers detailed reversal strategies based on monitoring capabilities, explaining how to prevent recurarization and safely manage these patients postoperatively.Beyond immediate management, we look toward a future where infiltration detection technologies and standardized guidelines are integrated into residency training and crisis checklists. This episode provides the missing guidance that anesthesia professionals need to navigate this surprisingly common complication with confidence.Have you experienced neuromuscular blocker infiltration in your practice? What strategies have worked for you? Share your thoughts or questions at podcast@APSF.org and join us in building a safer future where no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/269-infiltrated-iv-crisis-managing-complications-and-keeping-patients-safe/© 2025, The Anesthesia Patient Safety Foundation

Ever wondered what happens when neuromuscular blocking agents infiltrate into surrounding tissue instead of flowing smoothly through an IV? The consequences can be serious and potentially life-threatening for patients recovering from anesthesia.We dive deep into a complication that affects nearly 14% of the 150 million peripheral IV catheter insertions performed annually in the United States. While most healthcare providers have experienced IV infiltrations, few understand the unique dangers posed when paralytics like rocuronium leak into surrounding tissues. This scenario creates unpredictable pharmacokinetics with delayed absorption that can lead to secondary recurarization – muscle weakness and respiratory compromise that may occur hours after a patient appears to have fully recovered.Experts Dr. Andrea Vannucci and Dr. Karolina Brook share their insights and clinical experience on this important patient safety topic. They outline a comprehensive management approach including immediate interventions (attempting medication aspiration, establishing alternative IV access), treating the infiltration site (with nitroglycerin paste and hyaluronidase), and preventing recurarization through careful medication dosing and extended monitoring. Most critically, they recommend monitoring extubated patients for a minimum of four hours following infiltration of neuromuscular blocking agents – a practice not universally followed but essential for patient safety.Whether you're an anesthesiologist, CRNA, resident, or any perioperative clinician, this episode provides crucial information to help you recognize, manage, and prevent complications from this common but potentially dangerous event. Subscribe to the Anesthesia Patient Safety Podcast for more evidence-based strategies to protect your patients from harm.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/268-beyond-the-vein-the-dangers-of-infiltrated-muscle-relaxants/© 2025, The Anesthesia Patient Safety Foundation

Navigating the fine line between effective pain control and minimizing harm from opioid medications remains one of anesthesiology's greatest challenges. This episode dives deep into the evolving landscape of perioperative pain management, examining how clinicians can achieve the delicate balance required for optimal patient outcomes.Dr. Paul Guillod joins us to share his perspective as both an anesthesiologist and pain management specialist, highlighting how opioid-sparing techniques create opportunities for interdisciplinary collaboration and improved surgical recovery. We examine the substantial risks of traditional opioid-based approaches: respiratory depression, delayed bowel function, delirium, and paradoxically, opioid-induced hyperalgesia.The episode showcases promising research on multimodal analgesia strategies that target multiple pain pathways simultaneously. By combining regional anesthesia techniques with medications like NSAIDs, acetaminophen, ketamine, dexmedetomidine, and newer options like suzetrigine, clinicians can dramatically reduce opioid requirements while maintaining effective pain control. Real-world implementation of these approaches through Enhanced Recovery After Surgery (ERAS) protocols has yielded impressive results: 50% reductions in in-hospital opioid use, shortened hospital stays, and improved pain scores across multiple surgical specialties.Whether you're a clinician seeking to improve your pain management approach or simply interested in understanding how anesthesia care is evolving to address the opioid crisis, this episode offers valuable insights into creating safer, more effective perioperative experiences. Subscribe to the Anesthesia Patient Safety Podcast and join us in our commitment that no one shall be harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/267-beyond-opioids-revolutionizing-perioperative-pain-control/© 2025, The Anesthesia Patient Safety Foundation

Perioperative stroke represents a rare but potentially devastating complication of anesthesia care. While occurring in less than 1% of non-cardiac surgical patients, this complication fundamentally threatens not just patient outcomes but their very identity. As Dr. Jacob Nadler poignantly notes in our podcast, "By maintaining brain health, we're preserving the essence of who our patients are—their memories, their personality, their ability to connect with friends and family."The most significant recent development in this field comes from the 2024 joint guidelines that have dramatically shortened the recommended waiting period following stroke before elective surgery. What was once a nine-month wait has been reduced to just three months based on compelling evidence from a cohort study of 5.8 million patients showing risk stabilization after 90 days. This change has profound implications for surgical planning and patient care timelines.Anesthesia professionals must be vigilant about key risk factors including advanced age, previous stroke history, renal dysfunction, and anemia. The podcast explores critical medication management considerations, particularly regarding anticoagulation protocols, alongside specific intraoperative targets for blood pressure and hemoglobin levels. For suspected perioperative stroke, rapid multidisciplinary intervention with emergent brain imaging, possible thrombolytics, and mechanical thrombectomy may be indicated.For every anesthesia professional, this episode provides essential insights to help fulfill our commitment that no one shall be harmed by anesthesia care. Subscribe on Spotify or YouTube and share with colleagues to spread this vital safety information.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/266-protecting-the-brain-perioperative-stroke-prevention/© 2025, The Anesthesia Patient Safety Foundation

A revolution in pain management has arrived. The FDA's approval of Suzetrigine in January 2025 introduces the first non-opioid analgesic for moderate to severe pain in over twenty years. This breakthrough medication targets the voltage-gated sodium channel, NAV1.8, effectively blocking pain signals at their source before they reach the brain.What makes Suzetrigine remarkable is its precision. With over 30,000-fold selectivity for NAV1.8 channels, it delivers powerful analgesia without affecting the brain or heart, eliminating addiction risk, and minimizing side effects. Clinical trials involving over 2,100 patients demonstrated pain relief comparable to opioid-acetaminophen combinations but with a safety profile similar to placebo. For the more than 50% of surgical patients who experience moderate to severe postoperative pain, this non-addictive alternative represents a genuine breakthrough. Looking ahead, an exciting pipeline of additional NAV1.8 channel blockers, including intravenous formulations, promises to further transform perioperative pain management.Have you struggled with limited options for managing your patients' postoperative pain? Subscribe to the Anesthesia Patient Safety Podcast for more on groundbreaking developments like Suzetrigine that are changing how we approach patient care and safety. Leave us a review to share your thoughts on this revolutionary advance in pain management.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/265-the-breakthrough-drug-changing-perioperative-pain-management/© 2025, The Anesthesia Patient Safety Foundation

Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care.The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic events, OR emergencies often result from hemorrhage, embolism, hypoxemia, or critical drug reactions like malignant hyperthermia or local anesthetic toxicity. These scenarios demand immediate, specialized interventions beyond standard ACLS algorithms.Physical constraints further complicate matters. What happens when cardiac arrest occurs while a patient is positioned prone, lateral, or in steep Trendelenburg? Traditional compressions become impossible, and emerging research suggests prone CPR might actually be superior in some scenarios. Moreover, the advanced monitoring capabilities in the OR – arterial lines, central venous pressure readings, and echocardiography – provide critical data not incorporated into standard protocols.The American Society of Anesthesiologists has responded with their Perioperative Resuscitation and Life Support Certificate program, addressing these gaps through specialized training that combines ACLS principles with OR-specific knowledge.  Ready to enhance your skills beyond basic ACLS? Explore the ASA's certificate program to earn patient safety CME credits while gaining life-saving expertise tailored to the unique challenges of the operating room. Your specialized knowledge could make all the difference when seconds count.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/264-rethinking-resuscitation-in-the-operating-room-beyond-acls/© 2025, The Anesthesia Patient Safety Foundation

The standard of care for monitoring blood pressure during surgery hasn't changed in nearly 40 years, despite technological advances that could prevent serious complications and save lives. This eye-opening episode takes listeners inside a recent Capitol Hill briefing where healthcare professionals, lawmakers, and patient safety advocates made the case for continuous blood pressure monitoring as a critical patient safety measure.Alarming statistics frame the urgency of this issue: one in nine Americans undergoes surgery annually, with 88% experiencing potentially dangerous hypotension. Traditional arm cuffs that measure blood pressure only every few minutes leave dangerous blind spots where rapid drops may go undetected. The consequences can be devastating – kidney injury, heart damage, stroke, and even death. For pregnant women undergoing cesarean sections, the risks extend to their babies, with maternal hypotension potentially causing fetal acidosis and neurological compromise.With the United States maintaining the highest maternal mortality rate among wealthy nations and evidence showing that more than half of pregnancy-related deaths are potentially avoidable, this episode makes a powerful case for updating our standards. The technology exists, the evidence supports it, and the benefits are clear – it's time for healthcare providers, policymakers, and industry leaders to collaborate in making continuous blood pressure monitoring the new standard of care.Ready to become a champion for continuous blood pressure monitoring at your institution? Visit APSF.org to learn more about this lifesaving technology and join the movement to ensure no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/263-blood-pressure-blind-spots/© 2025, The Anesthesia Patient Safety Foundation

Ready for a refreshing summer dive into the latest anesthesia safety research? This episode explores three groundbreaking studies that could transform perioperative practice and patient outcomes.First, we examine a fascinating randomized clinical trial on "just-in-time" training for inexperienced clinicians performing infant intubations. The results are impressive: trainees who received just 10 minutes of structured training immediately before the procedure achieved a 91.4% first-attempt success rate—significantly better than the 81.6% rate in the standard training group. Could this approach revolutionize how we prepare for all high-stakes medical procedures? The study suggests decreased cognitive load and improved competency with this targeted preparation technique.Next, we explore a comprehensive meta-analysis of how intravenous antihypertensive medications affect cerebral blood flow. Good news: most medications maintain cerebral autoregulation even when reducing blood pressure. However, nitroprusside and nitroglycerin stand out as exceptions, potentially reducing cerebral perfusion even at appropriate doses. This critical information helps anesthesia professionals make more informed medication choices based on each patient's specific needs.Finally, we investigate emerging research on GLP-1 receptor agonist medications (increasingly popular for diabetes, weight loss, and cardiovascular disease) and their potential link to vision problems. Several studies suggest these medications may increase the risk of non-arteritic ischemic optic neuropathy—a leading cause of vision loss. While the absolute risk remains small and no direct connection to postoperative vision loss has been established, additional research is needed going forward.Each of these studies provides valuable insight into how we can continue improving anesthesia safety. Share this episode with your colleagues and join us next time as we work toward ensuring no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/262-medical-literature-deep-dive-from-infant-intubation-to-glp-1-agonist-risks-and-more/© 2025, The Anesthesia Patient Safety Foundation

Navigating the complex landscape of patient safety requires vigilance, knowledge, and adaptability. Today's episode takes us on a journey through two critical safety concerns that exemplify the challenges anesthesiologists face in diverse clinical settings.We begin with an eye-opening exploration of cosmetic surgery safety in Colombia, which has emerged as a top global destination for aesthetic procedures. Despite performing nearly 500,000 cosmetic surgeries annually, Colombia faces alarming safety statistics—mortality rates potentially ten times higher than global averages for anesthesia-related deaths. This stark disparity highlights how regulatory gaps, substandard facilities, and inadequate patient selection can create perfect storms for adverse outcomes. The discussion illuminates how anesthesiologists can serve as safety champions by implementing rigorous standards and protocols.The conversation then pivots to a surprisingly common yet overlooked danger in pediatric anesthesia: the administration of oxymetazoline. What seems like a routine medication becomes hazardous when delivery systems designed for upright, conscious patients are used on supine, anesthetized children. Through practical demonstrations and creative problem-solving, we uncover how simple modifications to delivery methods—specifically using atomizers with precisely filled syringes—can prevent potentially dangerous overdoses and create standardized, position-independent dosing.Both topics underscore a central theme: anesthesia safety demands thoughtful adaptation of standards to fit unique circumstances. Whether dealing with international variations in practice or the specialized needs of pediatric patients, the commitment to "no one shall be harmed by anesthesia care" requires constant vigilance and innovation. We'd love to hear your experiences with similar challenges—have you encountered safety variations in different practice settings, or developed creative solutions to common problems? Visit APSF.org to explore our resources and join the conversation about advancing anesthesia patient safety worldwide.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/261-patient-safety-challenges-from-global-cosmetic-tourism-to-pediatric-medication-dosing/© 2025, The Anesthesia Patient Safety Foundation

Dr. Elizabeth Malinzak takes us behind the scenes of a fascinating educational initiative bridging knowledge gaps in anesthesiology. As a pediatric anesthesiologist at Duke University and liaison between the Anesthesia Patient Safety Foundation and Open Anesthesia, she's spearheaded the development of over 30 patient safety and quality improvement summaries designed for today's learners.Malinzak reflects on crucial topics like crisis resource management, fatigue mitigation, and handover protocols that weren't part of traditional training. This educational void inspired her to create accessible, concise resources that meet modern learning preferences. Gone are the days of textbook deep-dives; today's professionals need searchable, digestible content they can absorb between cases or during brief study sessions.What makes these summaries particularly valuable is their breadth and collaborative development. Each summary is peer-reviewed and often created through mentoring relationships between experienced clinicians and trainees, creating educational value beyond the finished product. Malinzak offers a clarifying perspective on how quality improvement relates to patient safety: "Patient safety is the goal... That's what we want to accomplish with every single patient. Quality improvement is the process... how we get to the goal." As anesthesiologists face increasingly complex cases and efficiency pressures, this distinction helps practitioners develop systematic approaches to protect vulnerable patients. Looking ahead, she envisions technologies like AI reducing administrative burdens so clinicians can focus entirely on vigilant patient care. Discover these valuable resources by visiting Open Anesthesia's website and filtering for patient safety topics – you never know which summary might teach you something new today.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/260-openanesthesia-and-the-apsf-achieving-safe-and-quality-anesthesia-care-with-education-innovation/© 2025, The Anesthesia Patient Safety Foundation

Intrahospital transport of critically ill patients presents significant safety risks that can be mitigated through proper guidelines, checklists, and handoffs between care teams. The episode examines transport-related adverse events and complications while providing practical tools to enhance patient safety during these vulnerable transitions.• Multiple categories of intrahospital transport adverse events including respiratory, cardiovascular, neurological and equipment-related complications• Risk factors for transport complications including patient characteristics, transport circumstances, and team experience• Society of Critical Care Medicine guidelines focusing on four components: communication, personnel, equipment and monitoring• Comprehensive perioperative transport checklist covering identification, airway, breathing, circulation, neurological status and equipment• Multi-Center Handoff Collaborative tools providing structured approaches to handoffs between care teams• Recommendations including pre-transport risk assessment, education for all team members, and implementation of standardized checklists• Importance of system design considerations like uncluttered hallways and team formations that optimize patient observationThe deadline for the October 2025 APSF newsletter is July 1st. Check out the guide for authors at APSF.org for more information.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/259-every-move-matters-why-transport-safety-can-save-your-critical-patients/© 2025, The Anesthesia Patient Safety Foundation

The journey between hospital departments can be the most dangerous part of a patient's perioperative experience. This eye-opening episode dives deep into the hidden risks of intra-hospital patient transport. We examine the current literature on transport safety with particular focus on the challenges faced by anesthesia professionals. The data is sobering — between 4-9% of transported patients require medical intervention due to transport-related complications. With increasing production pressure, decreased support personnel, and rising patient acuity, we ask the critical question: are we transporting patients safely?We break down transport-related adverse events into essential categories: respiratory, cardiovascular, neurological, and equipment-related. The 2023 I-TOUCH study provides valuable insights, showing cardiac events, respiratory complications, neurologic issues, and equipment problems as the most common challenges during transport. We explore how patient factors (age, illness severity, ventilation requirements) and system factors (transport duration, communication gaps, staff experience) contribute to these risks.Beyond patient safety, we discuss the often-overlooked physical risks to anesthesia professionals themselves, who report high rates of work-related musculoskeletal injuries from maneuvering heavy transport equipment while managing patient care. The good news? Evidence-based guidelines exist to mitigate these risks. Join us next week as we continue this crucial conversation with practical recommendations from the American College of Critical Care Medicine and the Society of Critical Care Medicine for safer perioperative patient transport.Have you experienced challenges during patient transport? Share your experiences and learn from colleagues by emailing podcast@apsf.org or visiting apsf.org for more resources on perioperative safety.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/258-wheels-of-risk-when-patient-safety-rolls-through-hospital-corridors/© 2025, The Anesthesia Patient Safety Foundation

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have revolutionized treatment for type 2 diabetes, heart failure, and chronic kidney disease—but they're creating new challenges for anesthesia professionals. With more patients on these medications heading to surgery, understanding their unique perioperative risks has never been more critical.At the heart of this issue lies euglycemic ketoacidosis—a potentially life-threatening complication that's particularly insidious because it lacks the classic hyperglycemia that would normally trigger suspicion. We dive deep into the latest evidence, revealing that patients on SGLT2 inhibitors have an increased risk of developing postoperative ketoacidosis compared to those not taking these medications, with significantly worse outcomes when complications occur.We present a practical algorithm for risk stratification, considering factors like procedure duration, anesthesia type, diabetes control, and comorbidities. You'll learn which patients should hold their medication, which can proceed with caution, and what monitoring strategies to implement when patients haven't properly discontinued their medication before surgery. This guidance is especially valuable for emergency cases where postponement isn't an option.Whether you're developing institutional protocols or making decisions for individual patients, this episode equips you with the knowledge to navigate the complexities of SGLT2 inhibitor management in the perioperative period. Subscribe to stay informed about the latest in anesthesia patient safety and join our mission to ensure no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/257-sweet-trouble-perioperative-management-of-sglt2-inhibitors/© 2025, The Anesthesia Patient Safety Foundation

This is a Fresh Flow Podcast Takeover Show. The need for strong leadership in anesthesiology has never been more crucial. Join us as we discuss structured mentorship programs and the skills required to develop effective leaders in anesthesia. Dr. Mesrobian shares insights into cultivating future leaders and the importance of training in operational management.Here are some of the highlights:• Operating room management and operational efficiency directly impact physician wellness by reducing unpredictability• Balancing the demand side of anesthesia services represents a crucial opportunity for the specialty• Scale allows large organizations to develop standardized programs in patient experience and safety• Anesthesiologists possess unique abilities to manage complex operations that no one else in the hospital can match• Current residency programs need to incorporate leadership and operational training• Developing future leaders requires identifying those with leadership attributes and providing structured mentorship• The lines between academic and private practices are blurring as all face similar challenges• Hospital partners increasingly expect "skin in the game" with performance metrics tied to financial support• Standardization of processes offers opportunities to improve efficiency while maintaining safetyTo learn more about improving perioperative processes, check out the Fresh Flow podcast, a collaboration between University of Alabama Medicine and the Association of Anesthesia Clinical Directors.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/256-skin-in-the-game-a-fresh-flow-podcast-takeover/© 2025, The Anesthesia Patient Safety Foundation

Fear of the unknown is one of the most significant sources of anxiety for surgical patients. What exactly happens when we're "put under"? Could we wake up during surgery? What side effects should we expect? Our latest episode tackles these common concerns by exploring the APSF's Patient Guide to Anesthesia and Surgery.We walk through a simulated pre-surgical consultation, addressing the questions that weigh heaviest on patients' minds. We also explore factors affecting wake-up time, from medication choices to individual metabolism, and why some patients experience delayed emergence.The episode provides a comprehensive overview of potential side effects, from common temporary issues like dry mouth and nausea to rare serious complications. We discuss allergic reactions to anesthetics, distinguishing between true allergies, pseudo-allergic responses, and typical side effects. Throughout the conversation, we emphasize how patients can reduce their risks through open communication with their healthcare team, following pre-surgery instructions, and disclosing their complete medical history.Knowledge is power, especially when facing surgery. By understanding what happens during anesthesia and how medical professionals ensure safety throughout the process, patients can approach their procedures with greater confidence and participate more actively in their care. Share this episode with anyone preparing for surgery who deserves clear, factual information about what to expect during their anesthetic journey.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/255-what-you-need-to-know-before-going-under/© 2025, The Anesthesia Patient Safety Foundation

Fear of the unknown can make surgery and anesthesia unnecessarily stressful. Approximately 90% of patients experience some degree of anxiety about "going under" before their procedure – worrying about pain, waking during surgery, or post-operative grogginess. But what if patients had reliable answers to their most pressing questions?The Anesthesia Patient Safety Foundation has developed a groundbreaking resource to address this need. In this episode, we introduce the Patient Guide to Anesthesia and Surgery – a comprehensive tool designed to demystify the perioperative experience. Salvador Gullo Neto, lead of the APSF Patient Engagement Workgroup, explains why patient involvement matters: "If the patient is the primary stakeholder in their own safety, why are they left out of these conversations?" We explore the guide's three detailed sections – Anesthesia FAQ, Surgery FAQ, and Pain Management FAQ – covering everything from different types of anesthesia to essential questions patients should ask their clinicians before surgery. The guide addresses common concerns like the risks of anesthesia, what to expect during recovery, and options for managing post-operative pain. For medical professionals, it serves as a valuable reference during patient consultations.Healthcare has evolved from being done "for" patients to being done "with" patients as active participants. This shift represents the future of medical care – a collaborative approach where informed patients and dedicated healthcare professionals work together to achieve the best possible outcomes. We hope that you will check out this invaluable resource today and share it with patients, colleagues, and loved ones. Visit APSF.org or check our show notes for more information.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/254-the-patients-guide-to-anesthesia-and-surgery/© 2025, The Anesthesia Patient Safety Foundation

The safe management of non-cardiac implantable electrical devices during surgery requires careful planning and knowledge of device-specific considerations. We continue our discussion from last week with actionable recommendations for each stage of perioperative care.• Electrocautery poses significant risks including device reprogramming, thermal burns, and damage to neural tissue• Turn off devices or set to safe surgery mode before using electrocautery • Bipolar cautery is safer than monopolar; if monopolar is needed, use lowest power setting• Place grounding pads to minimize current through the device generator• Somatosensory evoked potentials (SSEPs) are relatively safe while motor evoked potentials (MEPs) should be avoided• Newer devices may be MRI conditional but require specific protocols including device interrogation• Regional anesthesia should use ultrasound guidance rather than nerve stimulation techniques• Neuraxial anesthesia is not contraindicated for spinal cord stimulator patients but must be placed below insertion level• ECT can be performed with device turned off and careful electrode placement• Devices should be turned back on before emergence from anesthesia• Postoperative evaluation should include checking for thermal injuries and neurologic changesThanks for joining us for our 253rd episode! Wow, 250 and counting! Go tell a friend or colleague about our show as we work toward 500 episodes. If you enjoy the Anesthesia Patient Safety Podcast, please give us a five-star rating, subscribe, and share with colleagues.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/253-when-electrocautery-meets-implanted-devices-what-every-anesthesia-professional-needs-to-know/© 2025, The Anesthesia Patient Safety Foundation

The podcast explores comprehensive recommendations for managing patients with non-cardiac implantable electrical devices during surgical procedures, emphasizing preoperative assessment, device interaction prevention, and safety protocols.• Types of devices include vagal nerve stimulators, deep brain stimulators, and spinal cord stimulators• Preoperative evaluation is crucial for identifying devices and contacting managing clinicians• Algorithm provided for assessing potential interactions with electrocautery, MRI, and neuromonitoring • Diathermy is absolutely contraindicated in patients with non-cardiac implantable devices• Critical information needed includes device type, manufacturer, lead locations, and latest interrogation results• Recent urgent safety alert issued about medication vial coring risks with specific interim recommendationsIf you have any questions or comments, please email us at podcast@apsf.org. Visit apsf.org for detailed information and check out the show notes for links to all topics discussed.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/252-managing-neurologic-stimulators-a-critical-guide-for-safe-anesthesia/© 2025, The Anesthesia Patient Safety Foundation

Surgical fires are devastating yet entirely preventable events that continue to occur in operating rooms around the world. This eye-opening episode features biomedical engineer Mark Bruley and anesthesiologist Dr. Jeffrey Feldman, who share decades of expertise investigating and preventing these catastrophic incidents.The conversation reveals why the seemingly simple recommendation to limit open oxygen delivery to 30% is so critical for patient safety. Through forensic investigations and laboratory testing, we learn how oxygen-enriched environments transform common surgical materials into dangerously flammable substances. The experts describe the "two-fold risk" created when oxygen concentrations exceed safe limits: materials ignite more easily and flames spread exponentially faster, putting patients at serious risk of harm.The experts outline clear, evidence-based approaches to prevent surgical fires, including the use of oxygen blenders for precise control and securing the airway when higher oxygen concentrations are clinically necessary. They share encouraging data showing significant reductions in surgical fire incidents over the past decade, while emphasizing that complete elimination is both possible and necessary.Whether you're an anesthesia professional, surgeon, or perioperative nurse, this episode provides essential knowledge to protect your patients from this preventable complication. Visit the APSF website for comprehensive resources, including videos and algorithms, to implement surgical fire prevention protocols at your institution. By understanding and applying these recommendations, we can work together to ensure no patient is ever harmed by a surgical fire again.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/251-surgical-fires-the-30-oxygen-rule/© 2025, The Anesthesia Patient Safety Foundation

Sugammadex safety considerations span across patient populations with renal impairment, pediatric patients, and pregnant or breastfeeding individuals, requiring nuanced clinical decision-making based on current evidence and ongoing research.• Sugammadex reversal of moderate blockade is safe and faster than using neostigmine/cisatracurium for patients with renal impairment• Quantitative neuromuscular monitoring is essential to ensure adequate reversal (TOF >90%)• FDA approval exists for children 2+ years with the same dosing parameters as adults• Infants

Discover the critical safety considerations when using Sugammadex, the seemingly "magical" neuromuscular blockade reversal agent that's fundamentally changed anesthesia practice. We delve deep into the science behind this medication and examine its use in three challenging patient populations: those with renal failure, pregnant patients, and pediatric patients.For patients with kidney dysfunction, we explore the fascinating pharmacokinetics of Sugammadex and how its primarily renal excretion creates potential complications. With a normal half-life of approximately two hours extending to a 19 hours in severe renal impairment, understanding the risk of recurarization becomes essential. Despite these challenges, recent research suggests Sugammadex may still offer advantages over traditional reversal agents in these patients.Pregnant patients present another complex scenario. Does Sugammadex bind to progesterone? What might this mean for maintaining pregnancy? We examine the current Society for Obstetric Anesthesia and Perinatology guidelines alongside emerging research that offers glimpses of hope for safe use. From animal studies to limited human case reports, we unpack what we know and the significant questions that remain unanswered.The conversation extends to breastfeeding considerations and emergency scenarios where the risk-benefit analysis shifts dramatically. Through expert insights and references to the latest studies, we provide practical knowledge for anesthesia professionals navigating these challenging clinical situations. This episode serves as a crucial reminder that despite advances in pharmacology, patient safety still demands individualized care, vigilant monitoring, and thoughtful application of evolving evidence.Want to further enhance your patient safety skills? Check out the Manual External Defibrillation course available at no cost through the ASA learning management system. Join us next week as we continue our discussion with a focus on pediatric patients and Sugammadex use.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/249-sugammadex-safety-special-populations-special-concerns/© 2025, The Anesthesia Patient Safety Foundation

Medication safety remains a cornerstone of anesthesia practice with complex environments and high-stakes decisions requiring vigilant attention to prevent errors. This collaboration between APSF and OpenAnesthesia spotlights critical aspects of perioperative drug safety with practical insights from Dr. Juan Li, a cardiothoracic anesthesia fellow at Beth Israel Deaconess Medical Center.• Perioperative anaphylaxis requires immediate recognition of cardiovascular, respiratory, and cutaneous manifestations• Neuromuscular blocking agents and antibiotics represent common triggers for anaphylactic reactions• Preoperative assessment must include thorough allergy history, medication reconciliation, and identification of drug-drug interactions• Standardized drug concentrations, preparation methods, and equipment minimize medication errors• Technology integration through barcode readers and computerized decision support enhances safety• Pharmacy support with pre-mixed solutions and pre-filled syringes reduces preparation errors• Post-operative monitoring remains critical for catching delayed medication reactions• Safety culture should emphasize root cause analysis rather than punishment for medication errors• Implementation of standard protocols is essential for managing new medications with limited safety dataVisit APSF.org and Openanesthesia.org for detailed information and resources on medication safety in anesthesia practice.

Climate change has arrived in the operating room, and pediatric anesthesiologists are taking action. Dr. Eva Lu-Boettcher, pediatric anesthesiologist and Director of Anesthesia Quality and Safety at the University of Wisconsin Children's Hospital, shares her journey toward sustainable anesthesia after witnessing firsthand the effects of climate change—including her Wisconsin community experiencing the world's worst air quality from wildfires.The healthcare sector contributes a staggering 8% of total U.S. greenhouse gas emissions, with anesthesia practices like high fresh gas flow during pediatric mask inductions representing significant contributors. Dr. Lu-Boettcher reveals how simple adjustments to match fresh gas flow with a patient's minute ventilation can dramatically reduce carbon emissions without compromising safety or induction effectiveness.What makes Dr. Lu-Boettcher's approach particularly fascinating is her application of behavioral science and "nudge theory" to achieve lasting change. By implementing default ventilator settings, providing comparative feedback to providers, and creating electronic reminders, her team achieved a remarkable 41% increase in compliance with sustainable practices. Ready to make your anesthesia practice more sustainable? Listen now to learn practical techniques for greener pediatric anesthesia care that maintains the highest safety standards while protecting our planet. The future of anesthesia must balance excellent patient care with environmental stewardship—and the time to start is now.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/247-nudge-your-way-to-greener-pediatric-anesthesia/© 2025, The Anesthesia Patient Safety Foundation

Dr. Liz Hansen takes us behind the scenes of a remarkable transformation at Seattle Children's Hospital, where pediatric anesthesiologists have reduced their greenhouse gas emissions by over 90% without compromising patient safety. A lifelong environmentalist and bike commuter, Dr. Hansen was shocked to discover that anesthesia gases contributed to 7% of her hospital's total emissions. This revelation sparked a personal and professional journey to align her clinical practice with her environmental values.The conversation reveals practical strategies for reducing anesthesia's carbon footprint, from eliminating nitrous oxide to implementing low-flow techniques. Dr. Hansen shares how her team gradually won over colleagues by demonstrating that sustainable practices could maintain or even improve patient outcomes. She offers detailed insights into working with child life specialists, adapting mask induction techniques, and using data tracking to drive continuous improvement.What makes this story particularly powerful is the ripple effect beyond a single institution. Dr. Hansen co-founded Project SPRUCE (Saving Our Planet by Reducing Carbon Emissions), an international consortium of anesthesia groups collaborating to reduce their environmental impact. Member organizations have already achieved their first-year goal of 50% emissions reduction, with more ambitious targets on the horizon.For anesthesia professionals concerned about climate change but unsure how to make a difference, this episode offers hope and concrete action steps. Remember, "the antidote to despair is action." Download the Yale Gassing Greener app, try a nitrous-free induction on your next cooperative patient, or advocate for addressing gas leaks in your facility's central supply system. Your individual choices matter, especially when they inspire others to follow your lead.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/246-ditching-nitrous-oxide-the-bike-commuters-guide-to-safe-and-sustainable-anesthesia/© 2025, The Anesthesia Patient Safety Foundation

In our latest episode, we dive headfirst into the growing issue of medical misinformation and its alarming effect on anesthesia patient safety. As patients increasingly turn to social media for health information, the risks of encountering inaccurate content have soared, posing challenges for healthcare professionals.Join us as we explore a recent article by George Tewfik and Raymond Malapero from the February 2025 APSF Newsletter, focusing on how misinformation can threaten patient safety, especially during critical procedures. We'll outline the detrimental consequences of misinformation, breaking them down into three distinct categories: fear and anxiety, delay of treatment, and avoidance of treatment altogether. Understanding the psychological and physiological impacts of misinformation is crucial for anesthesia professionals and helps to frame how we can best support our patients.You'll also learn actionable strategies for addressing these issues directly with patients. Empathy and compassionate communication are vital tools in combatting misinformation and fostering trust between healthcare providers and patients. By guiding patients towards reputable resources and encouraging open dialogue about their concerns, we can mitigate the effects of fear and anxiety, ultimately enhancing safety in anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/245-unmasking-medical-misinformation/© 2025, The Anesthesia Patient Safety Foundation

Join us as we dive into the critical topic of medical misinformation and its alarming impact on patient safety, particularly in the field of anesthesia. In this compelling episode, we unpack how misconceptions shape patient trust and communication with healthcare providers. Our conversation features insightful commentary from Dr. George Tewfik, who highlights real-world examples of how misinformation spreads and influences patient decisions. The rapid rise of social media as a primary information source has created a fertile ground for myths and misconceptions to thrive, leading to heightened anxiety among patients about anesthetic procedures.  Misinformation, such as exaggerated risks linked to medications like propofol and fentanyl, can cause unnecessary fear and even affect the consent process. As we walk through patient anxieties and barriers, we provide practical strategies for healthcare professionals to combat misinformation effectively. Emphasizing the need for transparent and empathetic communication, we aim to empower listeners with the tools to engage their patients constructively.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/244-battling-myths-and-misinformation-ensuring-patient-safety-in-anesthesia/© 2025, The Anesthesia Patient Safety Foundation

This episode delves into key findings in the literature, focusing on the nuances of neuromuscular blockade in pediatric patients and novel advancements in intubation techniques to enhance patient safety. We explore significant insights from recent studies that highlight age-related differences in recovery times from neuromuscular blockade and practical recommendations. We also discuss a novel flexible stylet for intubation and the implications of intravenous catheter design during emergency needle decompression.Highlights include:• Exploring age-based variability in neuromuscular recovery • Understanding the effects of volatile anesthetics on younger patients • Emphasizing the importance of quantitative monitoring in pediatrics • Introducing a new flexible intubation aid to enhance airway management • Discussing a case report on emergency needle thoracostomy • Practical recommendations for training to improve response in emergency situationsFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/243-unlocking-insights-for-safer-anesthesia-key-findings-from-the-literature-and-a-case-report/© 2025, The Anesthesia Patient Safety Foundation

Feeling overwhelmed about staying up to date with the anesthesia literature? We hope you will check out the APSF's In The Literature section. This resource brings you straightforward summaries of recent high-impact articles related to anesthesia patient safety. This episode highlights crucial updates in the literature concerning diabetes management, the impact of fatigue on anesthesia professionals, research about GLP-1 receptor agonists, and the use of methadone for next-day discharge surgery. These insights aim to enhance patient safety and improve the overall quality of anesthesia care.• Updates on blood glucose management guidelines for diabetic patients • Findings on the relationship between fatigue and patient safety • The risks of aspiration in patients taking GLP-1 receptor agonists • Insights on using methadone for pain control in outpatient surgeries • Discussion on the implications of recent research for clinical practiceFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/242-enhancing-anesthesia-patient-safety-literature-reviews-guidelines-and-recommendations/© 2025, The Anesthesia Patient Safety Foundation

This episode discusses the implementation of ISO 80369-6 neuraxial connectors in Japan, analyzing the challenges faced and the implications for patient safety. The conversation highlights the importance of clinician involvement and the need for clear communication and trials during the transition to new medical standards.• Overview of ISO 80369-6 and its significance in anesthesia care• Challenges faced in Japan during the implementation of new connectors• Historical context of the LOR connector and its risks• Importance of clinician involvement in product testing and standard formulation• Call for vigilance and advocacy among anesthesia professionals for patient safety when creating new medical devices and setting new standardsFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/241-the-impact-of-iso-80369-6-neuraxial-connectors-patient-safety-challenges-and-opportunities/© 2025, The Anesthesia Patient Safety Foundation

The episode explores the challenges and lessons learned from Japan's recent implementation of ISO 80369-6 standards in anesthesia practices, highlighting the critical importance of clinician involvement in developing safety protocols. We discuss the historical context, issues with communication, and various complications arising from the transition to new safety standards. • Importance of ISO standards in enhancing patient safety • Role of clinician input in developing safety protocols • Japan's experience with the implementation of ISO 80369-6 • Historical context of neuraxial connection standards • Issues arising from lack of communication during transitions • Challenges faced by healthcare professionals adjusting to new standards • Support structures needed for effective standards implementation • Lessons learned for global anesthesia practices regarding ISO standardsFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/240-enhancing-international-anesthesia-patient-safety-insights-on-iso-standards/© 2025, The Anesthesia Patient Safety Foundation

Unlock the potential to save lives with our exciting discussion on the Anesthesia Patient Safety Foundation's Technology Education Initiative course. Featuring Dr. Michael Kazior, an esteemed anesthesiologist and intensivist, we spotlight the crucial skills of manual external defibrillation, cardioversion, and pacing. Dr. Kazior shares his personal journey and highlights the stark educational gaps in defibrillator usage among anesthesia professionals. This course, born from the collaboration between the APSF and the American Society of Anesthesiologists, promises an interactive learning experience that aims to bolster confidence and competence in using these vital life-saving devices. Additionally, this course is a robust addition to the APSF's suite of courses, including those on low-flow anesthesia and quantitative neuromuscular monitoring, all designed to equip anesthesia professionals with comprehensive knowledge of essential technologies.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/239-enhancing-defibrillation-skills-the-apsfs-technology-education-initiative/© 2025, The Anesthesia Patient Safety Foundation

Can we significantly reduce pediatric medication errors in anesthesia care? This podcast episode explores the urgent need to address medication errors in pediatric anesthesia, highlighting effective strategies to improve patient safety. We discuss the implementation of tools such as the Anesthesia Medication Template, pre-filled syringes, and barcode scanning systems, as well as insights from experts on enhancing current practices.• Examination of medication error statistics in pediatric anesthesia• Discussion of the Anesthesia Medication Template (AMT) and its benefits• Overview of pre-filled syringes as a safety measure• Insights on challenges with pre-filled syringes • Evaluation of barcode scanning systems and their impact on safety• Expert opinions on future trends in medication safety• Emphasis on proactive strategies to prevent medication errors For healthcare professionals focused on refining patient safety, this episode is packed with practical insights and data-driven recommendations that could revolutionize your approach to pediatric care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/238-solutions-to-reduce-pediatric-medication-errors-during-anesthesia-care/© 2025, The Anesthesia Patient Safety Foundation

Unlock the secrets of preventing pediatric perioperative medication errors with insights from our esteemed guests, Eva Lu-Boettcher and Rahul Koka. Pediatric patients face unique challenges due to variations in body weight and dosing calculations, making them particularly vulnerable to medication errors. Join us as we explore the discrepancies between self-reported and observed error rates and gain a deeper understanding of the workflow vulnerabilities anesthesia professionals encounter. We also share findings from the Wake Up Safe Collaborative, revealing the administration phase as the most error-prone and illustrating how preventative and mitigative barriers can effectively manage risks through a bowtie analysis.Our commitment to enhancing patient safety doesn't end there. Discover the APSF Technology Education Initiatives, designed to equip anesthesia professionals with vital knowledge for safe practice. We highlight the Quantitative Neuromuscular Monitoring course, aligned with the ASA 2023 Practice Guidelines, as well as the importance of staying informed through courses on Low Flow Anesthesia and the upcoming Manual External Defibrillation, Cardioversion, and Pacing course. Our mission is to ensure that no one is harmed by anesthesia care, and this episode provides essential education and insights that every professional should incorporate into their practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/237-preventing-pediatric-medication-errors/© 2025, The Anesthesia Patient Safety Foundation

What if a simple change in routine could save lives in the operating room? Join us as we explore this possibility with Jonathan Charnin, who shares his expertise and passion for improving hand hygiene practices in anesthesia. Hand hygiene may seem like a small detail, but it plays a crucial role in preventing the spread of pathogens and reducing surgical site infections.We'll unravel the complexities behind implementing effective hand hygiene protocols and discuss the obstacles and opportunities that lie ahead. Discover the startling truth about how many hand hygiene events should occur during a routine anesthetic (hint: the answer is 8 times every hour). This episode promises to enrich your knowledge and commitment to patient care, as we highlight how meticulous attention to hand hygiene and environmental contamination can drastically improve outcomes in the perioperative setting.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/236-revolutionizing-hand-hygiene-in-anesthesia-a-path-to-safer-surgeries/© 2025, The Anesthesia Patient Safety Foundation

Join us on a fascinating exploration with Alli Bechtel, a dedicated anesthesiologist and the Anesthesia Patient Safety podcast host, who reveals the surprising journey from the United States to New Zealand in pursuit of a better work-life balance. Bechtel shares her unique insights into the supportive healthcare environment she found across the globe and the role of teamwork in ensuring patient safety in anesthesia. Her story provides a meaningful look at the personal and professional transitions involved in moving to a new country and how a close-knit hospital community can enhance medical practice.Discover the evolution of anesthesia patient safety initiatives and the pivotal contributions of the Anesthesia Patient Safety Foundation (APSF). Having joined the APSF during the pandemic, Alli recounts her path to becoming the host of their podcast, highlighting the foundation's dynamic shift from newsletters to engaging audio content. We discuss the APSF's commitment to collaboration and their comprehensive resources aimed at reducing errors and improving safety practices, sharing examples from recent publications that underscore the need for systemic solutions in anesthesia care.This episode is a compelling blend of personal narrative, professional insight, and pioneering education strategies aimed at shaping the future of anesthesia practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/235-fresh-flow-podcast-takeover-advancing-patient-safety-from-a-to-n-to-zed/© 2025, The Anesthesia Patient Safety Foundation

What does it take to stay prepared for a rare but potentially life-threatening anesthesia complication like malignant hyperthermia (MH)? Join us as Dr. Henry Rosenberg, a trailblazer in the field and founder of the Malignant Hyperthermia Association of the United States, shares his insights on the evolution of MH diagnosis and management. We promise you'll gain a deeper understanding of the transition from traditional muscle biopsy contracture tests to cutting-edge DNA diagnostic methods. Preparedness and vigilance are key themes as we explore the responsibilities of anesthesia professionals in ensuring patient safety for those susceptible to MH. We delve into the necessity of genetic counseling and multidisciplinary follow-up care, including consultations with geneticists and neurologists, to identify potential underlying conditions. Even if you never encounter a case of malignant hyperthermia in your career, understanding these strategies equips you to handle the unexpected. As we wrap up our discussions for 2024, we invite you to continue supporting our mission by sharing this knowledge-rich episode and leaving a five-star review. Your feedback drives our commitment to delivering valuable content on anesthesia patient safety.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/234-malignant-hyperthermia-preparedness-insights-and-updates/© 2024, The Anesthesia Patient Safety Foundation

Unlock the future of perioperative medicine with insights into remimazolam, the cutting-edge benzodiazepine poised to transform anesthesia practices. We uncover the remarkable features of remimazolam, from its rapid onset and short duration to its unique reversibility and minimal impact on cardiac and respiratory systems. Discover why this novel sedative is gaining traction for neurosurgery and neurology applications, especially for short procedures in the U.S. market.Explore the nuances of remimazolam's pharmacology, its economic considerations, and how it stands out in complex cardiovascular cases and interventional radiology. With practical insights into its effective use even in MRI procedures for patients with claustrophobia or spinal cord stenosis, this episode is your gateway to understanding how remimazolam is reshaping anesthesia with enhanced patient safety and recovery. This information was previously published in Episodes #175 and #176 and brought together to make one high-yield revisited show all about Remimazolam today.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/233-revolutionizing-anesthesia-the-impact-of-remimazolam/© 2024, The Anesthesia Patient Safety Foundation

What happens when a defective CO2 absorbent canister leads to ventilation failure during surgery? Our latest episode uncovers the hidden risks of hypoventilation and leaks in anesthesia machines following intra-procedure CO2 canister replacement. We discuss the critical role of manufacturers in providing warnings about potential equipment failures, the importance of backup systems, and the environmental considerations of CO2 absorbent usage and low flow anesthesia. By examining real-world scenarios and various ventilator types, we equip you with strategies to enhance patient safety, all while balancing the benefits of reduced gas flows with the ecological impact of absorbent materials. Tune in to explore these vital topics and the ways in which you can contribute to a safer future in anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/232-embracing-safety-and-sustainability-in-anesthesia-care/© 2024, The Anesthesia Patient Safety Foundation

What if a simple component replacement could jeopardize patient safety during surgery? Join us as we discuss critical anesthesia safety concerns with our special guest, Dr. Yuki Kuruma, an experienced anesthetist from Japan's Saiseikai Matsusaka General Hospital. Kuruma sheds light on the potential dangers of replacing CO2 absorbent canisters and the risk of hypoventilation caused by defective canisters. Reflecting on a significant 2013 incident involving a canister leak, we uncover why these issues remain pressing today and the urgent need for heightened awareness among anesthesia professionals.In addition to safety risks, this episode offers a valuable platform for addressing technology-related concerns in anesthesia care. Our rapid response column encourages listeners to submit their insights and experiences with tech-related safety issues, providing direct communication with industry experts and manufacturers. We aim to foster a proactive community dedicated to patient safety and vigilance. Don't miss this enlightening conversation that highlights the importance of staying informed and prepared to ensure the highest standards of care in anesthesia practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/231-ensuring-anesthesia-safety-risks-of-co2-canister-replacement-and-technology-concerns/© 2024, The Anesthesia Patient Safety Foundation

What impact do communication failures have on anesthesia patient safety, particularly for those with limited English proficiency? Join us as we welcome anesthesiology resident, Dr. Yasuko Mano, who sheds light on this critical issue. Drawing from her personal experiences and research, Mano reveals how language barriers can lead to less patient-centered care and increased risks during high-pressure situations like medication reconciliation and obtaining informed consent. Through her insights, we explore the often-overlooked moments in healthcare settings where communication breakdowns can lead to adverse outcomes, especially in perioperative care.Despite the availability of interpreter services in many hospitals, our discussion uncovers their underutilization at crucial times, such as during the initial check-in or induction of anesthesia. On the show, we outline a quality improvement initiative aiming to bridge these communication gaps. By proposing structural changes in preoperative and interoperative areas, the initiative seeks to enhance interactions between patients and the anesthesia care team with personalized translation tools. Together, we envision a future where high-quality and safe anesthesia care is accessible to all patients, regardless of language proficiency. Listen in to learn about practical solutions and the path toward more inclusive healthcare practices.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/230-bridging-communication-gaps-ensuring-safe-anesthesia-care-for-patients-with-limited-english-proficiency/© 2024, The Anesthesia Patient Safety Foundation

What if the future of dual antiplatelet therapy (DAPT) could be shorter, safer, and more effective? Uncover the latest insights into drug-eluting stents and how they are transforming how we think about dual-antiplatelet therapy. Join us as we examine the game-changing recommendations from top cardiology societies, which suggest that newer-generation stents can significantly reduce the duration of DAPT, particularly for patients with a high bleeding risk. Listen in as we dissect the innovative tools like the PRECISE-DAPT score and ARC-HBR criteria used to determine bleeding risk, ensuring patient safety without compromising on the efficacy of treatment. We delve into pivotal studies, including the Global Leader Study and the STOP-DAPT trial, that back these groundbreaking changes.Our conversation takes an intriguing turn as we explore the intersection of cardiology advancements with anesthesia practices. Discover how these developments are influencing preoperative settings, potentially altering surgical timing and decision-making in anesthesia care. We bring you exclusive insights from contributor, Janak Chandrasoma, featured in the October 2024 APSF newsletter. We urge you to explore further resources, share the knowledge with your peers, and join us in promoting patient safety in perioperative environments. Don't forget to rate, review, and share the episode with colleagues keen on staying at the forefront of anesthesia patient safety advancements.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/229-revolutionizing-anesthesia-care-for-cardiac-patients/© 2024, The Anesthesia Patient Safety Foundation

What if the future of cardiac care meant shorter duration of dual antiplatelet therapy without compromising safety? Join us as we explore this possibility with Dr. Joseph Szokol, a leading expert in clinical anesthesiology at the Keck School of Medicine of USC. Dr. Szokol shares his insights into the revolutionary advancements in drug-eluting stent technology, which are reshaping how we approach perioperative care and patient safety. With over 600,000 cardiac stents placed each year, this episode is a must-listen for understanding the evolving landscape and its implications for anesthesia professionals.Reflecting on past challenges, we transport you back to insights from the 2009 APSF newsletter that spotlighted the critical risks of stent thrombosis associated with older stent technologies. Discover how recommendations have dramatically shifted—from urging a 12-month delay for elective surgeries post-stent placement to adapting to breakthroughs in new generation stents. With a compelling narrative filled with historical context and cutting-edge research, this episode equips listeners with vital knowledge and updated guidelines that could significantly enhance perioperative patient management and safety.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/228-the-journey-of-drug-eluting-stents-and-anesthesia-patient-safety/© 2024, The Anesthesia Patient Safety Foundation

Join us for an enlightening conversation with documentary filmmaker Mike Eisenberg, where we explore the transformative role of technology in patient safety, inspired by his acclaimed film "The Pitch." Discover how pioneers like Jeff Cooper have shaped anesthesia patient safety and learn how the world of aviation offers valuable lessons for the healthcare industry. We promise you'll gain insights into how embracing technological innovations can not only reduce complications and costs but also improve safety outcomes across the board. You'll hear about the fascinating parallels between industries and the potential of predictive analytics to preemptively tackle issues like low blood pressure during surgery.In our discussion, we highlight the power of collaboration and storytelling in driving change within healthcare systems. We highlight the significance of dedicated events such as Patient Safety Awareness Week and World Anesthesia Day in bringing often-overlooked topics to the forefront. This episode underscores the collective effort needed to address patient safety issues, likening it to the global challenge of climate change. Listen in to understand the pivotal role of media and technology in shaping a safer future for patients worldwide.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/227-technologys-impact-on-patient-safety-insights-from-filmmaker-mike-eisenberg/© 2024, The Anesthesia Patient Safety Foundation

Documentary film director, Mike Eisenberg, shares his compelling journey from playing minor league baseball to directing films that change lives. Inspired by his late father, a prominent figure in patient safety, Eisenberg brings passion and insight to his exploration of patient safety in healthcare. His earlier work, "To Error is Human," laid the groundwork for a critical conversation on improving patient safety in healthcare systems. Now, Eisenberg introduces his sequel, "The Pitch," which confronts the evolving role of technology in this ongoing mission. Through personal stories and expert insights, we learn how these documentaries have resonated with audiences and sparked a movement for change.Our discussion takes an enlightening turn as we explore the cutting-edge innovations featured in Eisenberg's latest project. Our conversation highlights the vital role of technology in redefining patient safety. With a focus on the triumphs and trials faced by these innovators, listeners will gain a deeper understanding of how technological advances are shaping the future of healthcare and patient safety.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/226-from-the-ballpark-to-the-big-screen-patient-safetys-next-generation/© 2024, The Anesthesia Patient Safety Foundation

Can anesthesia care for patients with obstructive sleep apnea (OSA) impact patient safety during surgery? Join me, Alli Bechtel, as I unravel the complexities of managing anesthesia for OSA patients, drawing insights from experts like Mandeep Singh and his team, featured in the June 2024 APSF newsletter. This episode promises to enhance your understanding of the challenges and solutions in perioperative care for OSA patients, highlighting the importance of preoperative screening and the pressing need for structured postoperative guidelines. With the prevalence of OSA higher in surgical patients, the frequent lack of diagnosis poses significant risks, and together, we explore how clinical guidelines are working to change that narrative.The Society of Anesthesia and Sleep Medicine is at the forefront of the mission to keep sleep disorder patients safe, and I'm here to share their initiatives and collaborative efforts with you. From addressing the gaps in routine OSA screening to improving clinical training, this conversation is packed with actionable recommendations to elevate anesthesia care practices. Discover the significance of collaborative efforts with other medical societies to create comprehensive management guidelines that ensure patient safety. Whether you're directly involved in anesthesia care or interested in the latest advancements in patient safety, this episode is essential listening for navigating the complexities of OSA management in the perioperative period.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/225-collaborative-guidelines-for-safe-anesthesia-in-osa/© 2024, The Anesthesia Patient Safety Foundation

Wiretap laws might seem like a distant concern, but in the realm of clinical practice, they could be more relevant than you think. What if a simple audio recording could make or break your patient care approach? Join us as we unravel the complexities of wiretap regulations in healthcare with insights from Karolina Brook's enlightening APSF article, "Wiretap Laws: Relevance to Clinical Practice and Patient Safety." We'll explore how these laws differ across states, affecting everything from face-to-face conversations to phone calls, and discuss the potential penalties that could arise from unintentional violations. In our episode, we share practical tips for anesthesia professionals to navigate these legal waters, ensuring compliance while safeguarding privacy and safety. Whether you're an anesthesia professional or a legal enthusiast, this episode promises to equip you with valuable insights and strategies to remain informed and legally compliant.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/224-staying-legal-recording-conversations-during-anesthesia-care/© 2024, The Anesthesia Patient Safety Foundation

Ever wondered how wiretap laws impact your daily clinical interactions and patient safety measures? Discover the complexities of these laws with insights from our guest, Dr. Karolina Brook, an anesthesiologist from Boston Medical Center. Join us on the Anesthesia Patient Safety Podcast as we unravel the intricacies of one-party and all-party consent states, and explore how these decades-old statutes are more relevant than ever in our digital age. Dr. Brook shares her personal experiences of being recorded by patients, which fueled her exploration into the legal frameworks that continue to shape our practice today.Through our engaging discussion, you'll gain a deeper understanding of how state wiretap laws can affect anesthesia professionals. We delve into the nuances of what it means to practice in different consent jurisdictions and the importance of safeguarding patient trust while ensuring compliance. We navigate this rarely covered yet essential topic and provide valuable perspectives on the intersection of technology, legality, and patient safety—equipping you with the knowledge to better manage these real-world challenges in clinical practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/223-navigating-wiretap-laws-in-clinical-practice-insights-for-anesthesia-professionals/© 2024, The Anesthesia Patient Safety Foundation

Unlock the secrets to enhancing patient safety with our comprehensive discussion on the External Ventricular Drain (EVD) Safety Campaign. Ever wondered how to drastically reduce complications like ventriculitis? We promise you'll walk away with actionable insights, from the critical use of antimicrobial EVDs to the meticulous setup of devices by trained personnel under sterile conditions. We'll delve into essential preoperative steps such as patient history, neurological exams, and intracranial pressure (ICP) monitoring to ensure you're equipped with the best practices for patient care.Our episode doesn't stop there. We go further to unravel the intricacies of correctly leveling an EVD and the importance of monitoring ICP waveforms, especially during patient transport. Should you travel with the EVD clamped or open? We've got you covered with practical guidelines and key considerations for continuous monitoring. Don't miss out on this treasure trove of knowledge tailored for healthcare professionals committed to elevating patient safety. For more details and resources, visit APSF.org, and feel free to reach out to us with your questions at podcast@APSF.org.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/222-best-practices-for-external-ventricular-drain-management/© 2024, The Anesthesia Patient Safety Foundation

Curious about the best practices for managing patients with External Ventricular Drains (EVDs) during anesthesia and ICU transport? Join us as we talk to Dr. Abhijit Lele, a leading neuro-anesthesiologist and neuro-intensivist, who shares his expertise and personal journey from pediatrics to neuro-critical care. Discover the collaborative efforts between the Anesthesia Patient Safety Foundation (APSF) and the Society for Neuroscience and Anesthesiology and Critical Care (SNACC) aimed at improving the safety and outcomes for patients with EVDs.Dr. Lele provides invaluable insights into the complexities of neuro-critical care, shedding light on advanced monitoring techniques and quality improvement initiatives. Learn about his dedicated approach to managing severe neurological conditions in both perioperative and intensive care settings, and how his experiences have shaped his passion for global patient safety. Tune in for practical recommendations and expert knowledge that will enhance your practice and ensure your patients with EVDs receive the highest standard of care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/221-enhancing-patient-safety-in-neurocritical-care-best-practices-for-managing-external-ventricular-drains-with-dr-abhijit-lele/© 2024, The Anesthesia Patient Safety Foundation

Curious about how to enhance patient safety with external ventricular drains or EVDs? Join us as we unravel the intricacies of EVDs and their pivotal role in perioperative care. With over 25,000 EVD placements annually in the United States, it's crucial for anesthesia and critical care professionals to master the management of these devices to prevent serious complications. We delve into the fundamentals of EVDs, covering their function, placement, and the common risks associated with their use.This episode features the launch of the EVD Safety Campaign, a collaboration between the Anesthesia Patient Safety Foundation (APSF) and the Society for Neuroscience in Anesthesiology and Critical Care (SNACC). We'll discuss the campaign's objectives, which include raising awareness, providing education, promoting standardized guidelines, and enhancing clinical proficiency. Discover the wealth of resources available in the EVD Knowledge Hub, designed to equip healthcare professionals with the skills needed to ensure optimal patient outcomes. Tune in for a comprehensive guide on safeguarding patients with EVDs and elevating your clinical practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/220-enhancing-patient-safety-with-external-ventricular-drains-launching-the-evd-safety-campaign/© 2024, The Anesthesia Patient Safety Foundation

Unlock the secrets to improving anesthesia patient safety as we tackle the critical issue of intraoperative hypotension. Did you know that hypotension during surgery can lead to severe complications like acute kidney injury, myocardial injury, delirium, and stroke? Join us as we dissect recent studies, including one by Ariyarathna and colleagues linking high vasopressor use to kidney damage, and another by Chiu and colleagues on the dangers of limiting IV fluid administration. With expert insights from Amy Yerdon, Matt Scherrer, and Desiree Chappell, this episode is packed with essential information on minimizing hypotensive events and optimizing patient outcomes through advanced monitoring and goal-directed therapy.Stay ahead in your practice by understanding the differential diagnosis for intraoperative hypotension and the importance of continuous blood pressure monitoring. Learn strategies to balance fluid and vasopressor use effectively, ensuring patient safety. Whether you're an anesthesia professional or simply interested in medical advancements, this episode offers valuable knowledge and practical tips to enhance postoperative recovery. Don't miss out on these crucial insights that could transform your approach to anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/219-optimizing-outcomes-in-anesthesia-care-spotlight-on-intraoperative-hypotension/© 2024, The Anesthesia Patient Safety Foundation