Soc ie Vi ann ty of C sit us ual ritic at t con al C he gre are ss, M Boo edic th 4 ine 37
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The Independent Monthly Newspaper for Anesthesiologists AnesthesiologyNews.com • J a n u a r y 2 0 1 2 • Volume 38 Number 1
OR Itself May Promote Bacteria Contamination
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nesthesiologists are not the “typhoid Marys” of the operating room, according to a series of new studies which suggest that the surgical environment may pose infection risks to patients independent of clinicians. In three separate investigations that involved hundreds of ORs, Randy Loftus, MD, of Dartmouth-Hitchcock see environment page 22
Survey Finds ‘Discouraging’ Injection Habits Among Anesthesiologists
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new survey paints an at-times alarming picture of injection practices among anesthesiologists in New York state. Nearly half (49%) said they sometimes used the same vials of medication for more than one patient—a strict no-no for many kinds of drugs, including propofol. (Indeed, 31% of clinicians who reported using propofol said they had used the same vial on multiple patients.) Roughly one-fourth said they did not always use a new needle and syringe when drawing medication from a vial. And about the same proportion reported using an open vial of medication even though they had not directly observed someone else opening the container. see inject page 20
Bar-Code Scanning Can Fix ‘Black Hole’ of OR Drug Safety
INside 06 | COrrespondence Reader letters on first impressions and carbon dioxide.
Error rates slashed; anesthesiologists embrace technology New Orleans—When an anesthesiologist calls the operating room a “black hole of medication safety,” hospitals might want to pay attention. The description came from Ludwik Fedorko, MD, PhD, staff anesthesiologist at the University Health Network’s (UHN) Toronto General Hospital in Canada, during a session on OR drug safety at the 2011 American Society of Health-System Pharmacists anesthesiologists are the only health December meeting. care professionals in the hospiDr. Fedorko noted that tal setting who dispense, premix,
08 | Commentary
repackage, relabel and administer medications without independent verification. Given that most drugs administered perioperatively are high risk, the potential threat to patients is obvious. If that’s not enough to make hospital administrators uneasy, other figures presented by Dr. Fedorko are equally disconcerting: The OR and the postanesthesia care unit disproportionately accounted for 81% of all medication error reports, which
Pro/Con: Should clinical researchers shun industry funding?
12 | Pain Medicine Revisiting the APS/AAPM opioid guidelines three years later.
30 | Ad Lib Good drugs, bad doctors: Part 2 in a series on the history of anesthesia.
see black hole page 18
McMahonMedicalBooks.com Hadzic’s Peripheral Nerve Blocks and Anatomy for UltrasoundGuided Regional Anesthesia Admir Hadzic
see page 27
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anesthesianews EXPAREL™ from Pacira Pharmaceuticals, Inc., see insert at page 8, and page 18.