Vis
it u
sa
t AS
RA,
Boo
th 2
09
The Independent Monthly Newspaper for Anesthesiologists AnesthesiologyNews.com • M a r c h 2 0 1 2 • Volume 38 Number 3
Team Approach Slashes Central-Line Infections Houston—Can hospitals drive their rates of central-line bloodstream infections to zero? Although the goal sounds like a pipe dream, new research has found that multidisciplinary team approaches are making great strides in dramatically reducing rates. At the University of Massachusetts Memorial Medical Center in Worcester, for example, a team of clinicians dedicated to preventing central-line infections
Hospitals Feeling the Pain Of Sedative Shortage
I
n late January, the call went out at Rochester Medical Center in upstate New York. Clinicians were advised to dramatically cut back on their use of two mainstay IV sedatives, diazepam and lorazepam, supplies of which were becoming increasingly tight. Curtis Haas, PharmD, director of pharmacy at the hospital, sent an email to staff clinicians, stating that “we currently have very low supplies of both IV diazepam and IV lorazepam and have directed providers ... to use IV midazolam. However, we’re not counting on receiving any more shipments of any IV products until at least next week and maybe not until mid-February and do expect this shortage to be long-term.”
see team page 27
see shortage page 22
Laughter, and Tears, on the Way To Safer Anesthesia (Part 2)
INside
y March 1965 I had been promoted to Senior Registrar in Anaesthesia at the Middlesex Hospital, Mortimer Street, London, W,1. The Middlesex Hospital was, but no longer is, one of London’s best and most famous teaching hospitals. The hospital has been razed and the land is now devoted to growing weeds. I suspect the site of the hospital was chosen by its founders in the 1740s because of its proximity to The Cambridge, a rather nice pub across the road. In 1965, Consultants in Anesthesia wanted as much private work as they
12 | Pain Medicine
B
08 | COMMENTARY Protecting your practice in the “we” society.
could gather. This meant they had to make themselves available whenever a surgeon’s secretary phoned them and said, “Professor Turner-Warwick has a couple of cystoscopies at The London Clinic on Wednesday at about half-past two. Are you available then, Dr. Dinnick?” The answer was always ‘yes’ whether or not Dr. Dinnick was really available. No, meant he was supposed to anesthetize a list of National Health Service patients on Wednesday see laughter page 17
How to minimize infection risk from spinal cord stimulator surgery.
24 | Policy & Management Expert witness testimony—a cautionary tale.
34 | CLinical Anesthesiology Potassium check called a “low-yield” diversion for patients with renal failure.
40 | technology Continuous capnography lowers monitoring costs.
Educational Review
Paravertebral Blocks: The Evolution of a Standard of Care, see insert at page 32.
Special Report Addressing Current Challenges In Managing Postsurgical Pain With EXPAREL®, a new DepoFoam® Formulation Of Bupivacaine, see insert at page 24.
McMahonMedicalBooks.com Hadzic’s Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia Admir Hadzic,MD, PhD
see page 44