Umd N613 - Dates, People & Standards In Anesthesia (Joc)

Front 1

William T.G. Morton

Back 1

1846
Dentist who 1st used ether for surgical anesthesia @ MGH

Pt: Abbott
Surgeon: Dr. Warren

Front 2

1846

Back 2

First documented anesthesia usage for surgery

Front 3

Alice Magaw

Back 3

1893

The mother of anesthesia

Front 4

1893

Back 4

Alice Magaw & textbook on nursing includes first chapter of nurses role in anesthesia

Front 5

Agatha Hodgins

Back 5

1914
founder of NANA/AANA

declared CRNA's were the APNs

Front 6

1914

Back 6

Agatha Hodgins becomes important

Front 7

NANA/AANA

Back 7

1931 - founded (in OH)
1932 - incorporated
1933 - first meeting (WI)
1939 - changed name from NANA to AANA

Front 8

Isabel Hampton Robb

Back 8

1889 - nursing leader & superintendent of JHUSON

1893 - wrote textbook on nursing & included chapter on nurses in anesthesia

Front 9

1944

Back 9

first African American in nurse anesthesia

Front 10

1945

Back 10

first certification exam in nurse anesthesia

Front 11

1947

Back 11

first male in nurse anesthesia

Front 12

1957

Back 12

CRNA title incorporated by AANA

Front 13

1974

Back 13

Standards of Practice adopted by AANA

Front 14

1989

Back 14

direct reimbursement for CRNAs under medicare part B

Front 15

1998

Back 15

graduate level education required for CRNA profession

Front 16

2001

Back 16

1st state to opt out of the federal physician supervision requirement - Iowa

Front 17

Standards

Back 17

rules or minimum requirements for clinical practice

Front 18

Guidelines

Back 18

recommendations to assist in decision making about health care

Front 19

Sole purpose of an anesthetist

Back 19

...to provide safety & vigilance.

Front 20

Standards of Nurse Anesthesia Practice

Back 20

- Perform & complete a preanesthesia assessment.
- Obtain informed consent
- Formulate a specific plan-of-care
- Implement/adjust plan based on patient's physiological response
- Monitor physiologic condition
- Documentation; complete, accurate & timely
- Transfer of care to qualified providers
- Adhere to safety precautions of institution
- Minimize risk of infection
- Assure quality and contribution to positive patient outcomes
- Respect the rights of the patient

Front 21

Standards of basic anesthesia monitoring

Back 21

- qualified anesthetist will be present at all times during general, regional and MA care
- during anesthesia the patient will be...monitored (including oxygenation, ventilation, circulation & temperature)
- ...ensured adequate ventilation
- ...ensured adequate circulatory function
- Aided in body temperature maintenance

Front 22

Insurances of anesthetist for adequate oxygenation

Back 22

oxygen analyzer & pulse oximetry

Front 23

Insurances of anesthetist for adequate ventilation

Back 23

- Qualitative signs (chest rise, auscultation of BS, ETCO2, observation of reservoir bag)
- Quantitative signs (volume of expired gas)

ETCO2 detector

Vent alarms

Front 24

Insurances of anesthetist for adequate circulation

Back 24

Continuous EKG monitoring

arterial/NBP q5min

cont eval of either palpable pulse, auscultation of heart sounds, monitoring of intrathecal pressure, US peripheral pulse, pulse oximetry/plethysmorgraphy

Front 25

CRNA scope of practice

Back 25

1.) perform/document preanesthetic eval
2.) develop anesthesia plan
3.) initiating anesthetic technique
4.) select/apply/insert appropriate NI/I monitoring
5.) select/obtain/admin anesthetics/IVF
6.) manage pt's airway and pulm statues
7.) facilitate emergence/recovery from anesthesia
8.) d/c patient from PACU and provide f/u care
9.) implement acute & chronic pain modalities
10.) respond to emergency situations (airway management, IVF/drugs, BLS/ACLS)

Front 26

CRNA code of ethics

Back 26

1.) preserve human dignity
2.) maintain competence in practice
3.) responsible/accountable for services provided
4.) collaborate w/ HCT; promote communication
5.) endorse products/services when safe & effective
6.) protect integrity of research/publication
7.) maintain ethical business practices in all professional settings

Front 27

The gold standard for knowing correct ETT placement is...

Back 27

ETCO2 (easy cap, colorimetric detection)

**Can only determine the presence of CO2, but does not evaluate ventilation**

Front 28

Set point for normothermia is...

Back 28

98-98.6*F
36.4-37*C

At temp above set point, body will sweat (heat loss > heat production)
At temp below set point, body will shiver (heat production > heat loss)

Front 29

Credentialing

Back 29

Recognition of professional and technical competence and well-defined criteria-based mechanisms to verify information and evaluate applicant

Front 30

Core privileges

Back 30

Scope of procedures and activities within a specialty that each professional has the education, experience and competence to perform

Front 31

Clinical privileges

Back 31

The process through which individuals are credentialed within institutions.