What happens when we truly listen to patients' fears about anesthesia? The Anesthesia Patient Safety Foundation (APSF) discovered something remarkable: despite the wealth of medical information available, patients' most pressing questions about anesthesia remained largely unanswered in accessible language. This episode delves into the groundbreaking work of the APSF Patient Engagement Workgroup, featuring insights from Maria Van Pelt. We explore how this initiative transformed patient concer...
Every anesthesia professional has encountered IV infiltration—but when neuromuscular blocking agents are involved, this common complication becomes a complex patient safety challenge with no established guidelines. This episode delves into the critical management of infiltrated paralytics, a complication affecting 14% of peripheral IV catheterizations that can lead to delayed induction, compromised emergence, and potentially serious tissue injury. We're joined by Dr. Govind Rangrass, Profess...
Ever wondered what happens when neuromuscular blocking agents infiltrate into surrounding tissue instead of flowing smoothly through an IV? The consequences can be serious and potentially life-threatening for patients recovering from anesthesia. We dive deep into a complication that affects nearly 14% of the 150 million peripheral IV catheter insertions performed annually in the United States. While most healthcare providers have experienced IV infiltrations, few understand the unique danger...
Navigating the fine line between effective pain control and minimizing harm from opioid medications remains one of anesthesiology's greatest challenges. This episode dives deep into the evolving landscape of perioperative pain management, examining how clinicians can achieve the delicate balance required for optimal patient outcomes. Dr. Paul Guillod joins us to share his perspective as both an anesthesiologist and pain management specialist, highlighting how opioid-sparing techniques create...
Perioperative stroke represents a rare but potentially devastating complication of anesthesia care. While occurring in less than 1% of non-cardiac surgical patients, this complication fundamentally threatens not just patient outcomes but their very identity. As Dr. Jacob Nadler poignantly notes in our podcast, "By maintaining brain health, we're preserving the essence of who our patients are—their memories, their personality, their ability to connect with friends and family." The most signif...
A revolution in pain management has arrived. The FDA's approval of Suzetrigine in January 2025 introduces the first non-opioid analgesic for moderate to severe pain in over twenty years. This breakthrough medication targets the voltage-gated sodium channel, NAV1.8, effectively blocking pain signals at their source before they reach the brain. What makes Suzetrigine remarkable is its precision. With over 30,000-fold selectivity for NAV1.8 channels, it delivers powerful analgesia without affec...
Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care. The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic...
The standard of care for monitoring blood pressure during surgery hasn't changed in nearly 40 years, despite technological advances that could prevent serious complications and save lives. This eye-opening episode takes listeners inside a recent Capitol Hill briefing where healthcare professionals, lawmakers, and patient safety advocates made the case for continuous blood pressure monitoring as a critical patient safety measure. Alarming statistics frame the urgency of this issue: one in nin...
Ready for a refreshing summer dive into the latest anesthesia safety research? This episode explores three groundbreaking studies that could transform perioperative practice and patient outcomes. First, we examine a fascinating randomized clinical trial on "just-in-time" training for inexperienced clinicians performing infant intubations. The results are impressive: trainees who received just 10 minutes of structured training immediately before the procedure achieved a 91.4% first-attempt su...
Navigating the complex landscape of patient safety requires vigilance, knowledge, and adaptability. Today's episode takes us on a journey through two critical safety concerns that exemplify the challenges anesthesiologists face in diverse clinical settings. We begin with an eye-opening exploration of cosmetic surgery safety in Colombia, which has emerged as a top global destination for aesthetic procedures. Despite performing nearly 500,000 cosmetic surgeries annually, Colombia faces alarmin...
Dr. Elizabeth Malinzak takes us behind the scenes of a fascinating educational initiative bridging knowledge gaps in anesthesiology. As a pediatric anesthesiologist at Duke University and liaison between the Anesthesia Patient Safety Foundation and Open Anesthesia, she's spearheaded the development of over 30 patient safety and quality improvement summaries designed for today's learners. Malinzak reflects on crucial topics like crisis resource management, fatigue mitigation, and handover pro...
Intrahospital transport of critically ill patients presents significant safety risks that can be mitigated through proper guidelines, checklists, and handoffs between care teams. The episode examines transport-related adverse events and complications while providing practical tools to enhance patient safety during these vulnerable transitions. • Multiple categories of intrahospital transport adverse events including respiratory, cardiovascular, neurological and equipment-related complication...
The journey between hospital departments can be the most dangerous part of a patient's perioperative experience. This eye-opening episode dives deep into the hidden risks of intra-hospital patient transport. We examine the current literature on transport safety with particular focus on the challenges faced by anesthesia professionals. The data is sobering — between 4-9% of transported patients require medical intervention due to transport-related complications. With increasing production pres...
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have revolutionized treatment for type 2 diabetes, heart failure, and chronic kidney disease—but they're creating new challenges for anesthesia professionals. With more patients on these medications heading to surgery, understanding their unique perioperative risks has never been more critical. At the heart of this issue lies euglycemic ketoacidosis—a potentially life-threatening complication that's particularly insidious because it lacks the...
This is a Fresh Flow Podcast Takeover Show. The need for strong leadership in anesthesiology has never been more crucial. Join us as we discuss structured mentorship programs and the skills required to develop effective leaders in anesthesia. Dr. Mesrobian shares insights into cultivating future leaders and the importance of training in operational management. Here are some of the highlights: • Operating room management and operational efficiency directly impact physician wellness by reducing...
Fear of the unknown is one of the most significant sources of anxiety for surgical patients. What exactly happens when we're "put under"? Could we wake up during surgery? What side effects should we expect? Our latest episode tackles these common concerns by exploring the APSF's Patient Guide to Anesthesia and Surgery. We walk through a simulated pre-surgical consultation, addressing the questions that weigh heaviest on patients' minds. We also explore factors affecting wake-up time, from me...
Fear of the unknown can make surgery and anesthesia unnecessarily stressful. Approximately 90% of patients experience some degree of anxiety about "going under" before their procedure – worrying about pain, waking during surgery, or post-operative grogginess. But what if patients had reliable answers to their most pressing questions? The Anesthesia Patient Safety Foundation has developed a groundbreaking resource to address this need. In this episode, we introduce the Patient Guide to Anesth...
The safe management of non-cardiac implantable electrical devices during surgery requires careful planning and knowledge of device-specific considerations. We continue our discussion from last week with actionable recommendations for each stage of perioperative care. • Electrocautery poses significant risks including device reprogramming, thermal burns, and damage to neural tissue • Turn off devices or set to safe surgery mode before using electrocautery • Bipolar cautery is safer than mono...
The podcast explores comprehensive recommendations for managing patients with non-cardiac implantable electrical devices during surgical procedures, emphasizing preoperative assessment, device interaction prevention, and safety protocols. • Types of devices include vagal nerve stimulators, deep brain stimulators, and spinal cord stimulators • Preoperative evaluation is crucial for identifying devices and contacting managing clinicians • Algorithm provided for assessing potential interactions...
Surgical fires are devastating yet entirely preventable events that continue to occur in operating rooms around the world. This eye-opening episode features biomedical engineer Mark Bruley and anesthesiologist Dr. Jeffrey Feldman, who share decades of expertise investigating and preventing these catastrophic incidents. The conversation reveals why the seemingly simple recommendation to limit open oxygen delivery to 30% is so critical for patient safety. Through forensic investigations and la...