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AnesthesiologyNews.com • J a n u a r y 2 0 1 5 • Volume 41 Number 1
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Perioperative Red Tape: Streamlining Workflow
Success of Spinal Lower for turients
Christine Doyle, MD
A
sk 100 physicians—whether suurgeons, anesthesiologists or other MDs—to name their favorite part of practicing medicine, and not one would cite rred tape or paperwork. These requirements pllay an important role, however, so often theyy’re considered a necessary evil. In recent years, regulatory and quallity measures have grown exponentially, increasing in both number andd complexity. HIPAA, Surgical Quaality Improvement Project (or SCIP), an nd
New Orleans—A review of o more than 5,000 patient records has concluded that women undergoing preterm cesarean delivery have a signiificantly higher risk for failed spinal anesthesia than womeen undergoing the procedure at full term. These findingss, reported by a Duke University research team at the 2014 annual meeting of the American Society of Aneesthesiologists, suggest that an increased spinal dose—oor combined spinal–epidural technique—may be neceessary to reliably ensure adequate anesthesia in this poopulation. Although studies have examined the relative spread of spinal block for surgicaal anesthesia in pregnant and
see red tape e page 26
see preterm spinal page 5
MOCA Push-Back
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Who controls certification? In 2000, the American Board of Anesthesiology (ABA) Robert E. Johnstone, MD changed its process, making new our decades ago, board certification was a mark certificates temporary, good for of excellence, a goal for achievers and not a 10 years only, and developed practice requirement. Certification designated requirements and fees to renew an anesthesiologist with consultant-level knowl- them. Other organizations, pri- Robert E. Johnstone, MD edge and extraordinary capabilities. But times have marily the American Society of Anesthesiologists, develchanged. Many institutions and groups now require oped products and programs that anesthesiologists could certification for clinician credentialing. No certifica- buy to meet these requirements. The laudable goals tion increasingly means practicing at small hospitals included lifelong professional development for clinicians, in temporary positions. see MOCA page 27
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ffor iPad 2014 The Top 10 Articles of 2014 on AnesthesiologyNews.com see page 4
CLINICAL ANESTHESIOLOGY
Perioperative risk factors mapped for noncardiac surgery patients >80 years
see pages 4 and 17
REPORT Enhanced Recovery Pathways for Major Abdominal Surgery see insert at page 16
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CLINICAL ANESTHESIOLOGY
NAP5 finds accidental awareness cases most often involve a neuromuscular block
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PAIN MEDICINE
Study sheds light on link between primary and referred pain
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PRN
The history of the development of blood transfusion
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COMMENTARY
Electronic devices act as vectors of infection in today’s wired world