Eur Pleas oan e vi s boo aesth it us a th # esia t 03. 20 511 11
The Independent Monthly Newspaper for Anesthesiologists AnesthesiologyNews.com • M a y 2 0 1 1 • Volume 37 Number 5
To Assess Tube Placement, Keep it Simple Depth measurement bests auscultation in new study
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ilateral auscultation, the current gold standard to detect misplacement of an endotracheal tube during intubation, frequently provides inconclusive results. Serious complications, such as hypoxemia, right-sided barotrauma and left-sided atelectasis, can occur from inadvertent placement of the tube in a mainstream bronchus.
After Retractions in Boldt Case, Experts Ponder the Fate Of Hetastarch
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nesthesiologists and other clinicians in Europe and the United States are re-evaluating their use of hydroxyethyl starch for fluid management in surgery as investigators continue to probe the veracity of nearly 90 studies authored by now-disgraced German anesthesiologist Joachim Boldt, MD, PhD. On March 1, the Association of Surgeons of Great Britain and Ireland announced that citations referring to six studies authored by Dr. Boldt, who was forced out of his position at the Klinikum
see ETT page 17
see HES page 24
INside
Electronic Reminders Prompt Improved Ventilation Strategies
10 | technology Running on empty: New alarm signals when vaporizers are low on gas.
21 | Clinical
But even alerts can’t completely overcome bad habits
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n automated alert sent to the pagers of anesthesia providers may increase the use of lung-protective ventilation strategies for patients with suspected acute lung injury, new research has found. Every year, an estimated 190,600 people in the United States experience critical lung damage. Of those, approximately 40% do not survive. “Patients with acute lung injury [ALI] have very high mortality, yet there’s very little data supporting
improvements other than the use of lower tidal volume ventilation,” said James Blum, MD, director of critical care research in the Department of Anesthesiology at the University of
Speedy preanesthetic stress assessment pleases patients.
Michigan Medical Center, in Ann Arbor. “We were curious to find out if patients who went into the operating room got this low tidal volume ventilation when they had lung injury,” Dr. Blum added. “The answer is, for the most part, they don’t.” To see if a reminder might help, Dr. Blum and his colleagues randomly selected 22 providers to receive electronic notifications alerting them of patients with
26 | Policy & Management Firm grasp of technology key to success in anesthesiology.
34 | Pain Medicine Are ex-NFLers prone to opioid abuse?
McMahonMedicalBooks.com Smith’s Anesthesia for Infants and Children: Eighth Edition Peter J. Davis, Franklyn P. Cladis, Etsuro K. Motoyama see page 40
see remind page 11
Educationalreview
Featuredproduct
Newproduct
Arrow® FlexTip Plus® from Teleflex, see pages 17 and 28.
BleaseSirius Electronic Flow Meter from Spacelabs, see pages 5 and 26.
Current Concepts In the Management Of the Difficult Airway, see insert after page 22.