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AnesthesiologyNews.com • O c t o b e r 2 0 1 3 • Volume 39 Number 10
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VISIT US AT ANESTHESIOLOGY 2013 BOOTH #705
Fluid Protocol Promises New ERAS In Surgery San Diego—Programs that promote enhanced recovery after surgery are beneficial for both patients and institutions, according to a recent study that supports the use of the increasingly common treatment plans. Popularized in Europe, so-called ERAS programs are becoming more widespread in the United States, although the data for their overall efficacy here are still lacking. The latest study should help. North Carolina researchers found that surgical patients undergoing see ERAS page 36
ASA Blasts Proposed Change To VA Nursing Guidelines
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he American Society of Anesthesiologists is calling “ill-conceived” a draft document from the Veterans Health Administration that, it claims, would require nurse anesthetists to practice without physician supervision and in the process jeopardize patient safety. The ASA says the new rules abandon “team-based anesthesia care” led by physicians and undermine the quality of care in VA hospitals in the service of further expanding the scope of practice of advanced practice nurses (APRNs) and other so-called physician extenders. But see VA change page 26
Doctor Onboard
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lexander Popov, MD, has the heaviest clinic on the planet. Dr. Popov is chief medical officer on the Oasis of the Seas, a Royal Caribbean liner that, at about 225,000 tons, is the largest cruise ship on the ocean— roughly 4.5 times heftier than the Titanic. Dr. Popov, v an anesthesiologist, along with two other physicians and five nurses, is responsible for the medical care of the 6,300 guests and 2,200 crewmembers on board every time the Oasis of the Seas leaves port.
Dr. Popov was trained in Bulgaria andd worked in South Africa. While there, he read an adveertisement in a Souuth African journall for ships’ doc-tors and appliedd. a special Requirements for interest in ortho-the position included cluded pedics and regional anesthesia— three years of experience in inter- he was hired. He also speaks four nal medicine and/or training in languages fluently—Russian, Bulcritical care. Because Dr. Popov garian, German and English— had surgical training, a fellowship helpful on a cruise ship with many in pulmonology and board quali- international travelers. fications in anesthesiology—with see sea page 16
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COMMENTARY
NPO: Never Prudently Ordered (or Nonliterate Palaveric Officialese).
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TECHNOLOGY
Reclaiming PGY-1 ‘Lost Year’.
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CLINICAL ANESTHESIOLOGY
Rethinking anesthesia care for ankle surgery.
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CME: PREANESTHETIC ASSESSMENT
Lesson 306: Management of the Patient At Risk for an Operating Room Fire: Part 1
24 Perioperative Patient Monitoring: Utilizing BIS In Total Intravenous Anesthesia Procedures (Part 3 of a 3-Part Series)