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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • A p r i l 2 0 1 5 • Volume 41 Number 4
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ASA Membership: Some Say No
Closed Claims Airway Injury Analysis Spotlights Problems
Are changes needed?
A
Robert E. Johnstone, MD
I
practice anesthesiology, so I belong to the American Society of Anesthesiologists (ASA). The ASA organizes the specialty, develops standards, unites me with colleagues and represents us to the public. I joined in medical school, and have benefited in myriad ways since. But some anesthesiologists
lthough 15 years have passed since the last airway injury analysis of the American Society for Anesthesiologists (ASA) Closed Claims Project, new research reveals that pharyngeal and esophageal perforations continue to be a significant source of patient morbidity and mortality—as well as liability for anesthesiologists. The investigators noted, however, that practitioner diligence is key to reducing the severity of these sometimes-fatal injuries. “In 1999, Domino et al published a review of airway injuries [Anesthesiology [
see ASA page 46
see airway page 18
Administering Death, Terminating Suffering Baby boomers fuel growing interest in the right to die; physicians’ role still hotly debated
I
n November 2014, Brittany Maynard ended her life in Oregon, availing herself of that state’s right to die law. Young, attractive and willing to speak with candor about her decision, Maynard captured the nation’s attention. A month later, in Baltimore, Lawrence Egbert, MD, an 87-year-old anesthesiologist, trained at Johns Hopkins University and the University of Maryland, lost his
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CLINICAL ANESTHESIOLOGY
Goal-directed fluid therapy reduces post-op morbidity and health care costs.
medical license for allegedly helping six Maryland residents end their lives. Maynard and Egbert are two faces from the same conversation, grabbing headlines and reinvigorating the debate over physician-assisted suicide—or what proponents call physician aid-in-dying—and what role, if any, doctors should have in helping sick individuals end their lives. see assisted page 36
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POLICY & MANAGEMENT
Bundled payment arrangements require negotiation armed with data.
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TECHNOLOGY
Biomedical informatics may revolutionize medical research and patient care.
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COMMENTARY
A Passover metaphor on the incidence of adverse events.
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CME: PREANESTHETIC ASSESSMENT
Lesson 315: Assessment of the Neonate With Patent Ductus Arteriosus
EDUCATIONAL REVIEW Perioperative Anesthesia Care for Obese Patients, see insert after page 56.
NEW PRODUCT see pages 7 and 22 A7 Anesthesia Workstation from Mindray
ffor iPad see page 4
REPORT Managing Venous Thromboembolism Risk in Hereditary Antithrombin Deficiency see insert at page 28