The Sixth Annual
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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • A u g u s t 2 0 1 3 • Volume 39 Number 8
Misplaced Nerve Blocks Frustrate Efforts at Prevention
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Momentum Builds For Permanent SGR Fix
lthough not as sensational or disastrous as wrong-site surgeries, wrong-site peripheral nerve blocks are potentially dangerous, and according to a 10-year analysis by Pittsburgh researchers, 10 times more common than their surgical counterparts. Yet the problem can be largely— if not entirely—avoided with better planning, vigilance and engagement by the various members of the care team.
Anesthesiologists applaud reform efforts, but want long-standing payment disparity fixed, too
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n a Thursday in early June, Andy Harris, MD, an anesthesiologist and a Republican congressman from Maryland, convened a meeting for some of his colleagues in the House. The sole topic on the agenda was a bugbear familiar to physicians and lawmakers alike: the Sustainable Growth Rate (SGR) system of physician payment under Medicare. In attendance was Jane Fitch, MD, chair of anesthesiology at the University of Oklahoma Health Sciences Center, in
see wrong page 42
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“Biological death is not an event, but a process. Anesthesiologists participate in the decision making and the establishment of these criteria and we should establish clear and unequivocal criteria for the diagnosis of death, knowing the emerging ethical implications,” said Ricard Valero, MD, PhD, senior consultant anesthesiologist at the Hospital Clinic de Barcelona, during a presentation in June at the 2013 annual Euroanaesthesia meeting, in Barcelona, Spain. “There needs to be consensus around a practical and concrete definition of death … based on measurable see consensus page 44
E-NEWSLETTER 2013-2014
Corporate ANNUAL Profiles see page 17
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see SGR page 16
Europeans Call for Anesthesiologists To Take Lead in ICU Death Declarations nesthesiologists should play a greater role in the determination of death in the ICU and emergency department to help facilitate organ transplantation and resolve ongoing ethical and medical practice issues, according to a group of European physicians. And because different countries, cultures and religions embrace varying standards, an international consensus is needed to determine when and under what circumstances death has occurred, experts advised. However, they added, such agreement is unlikely given the depth of those differences.
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08 | PRN Inside deadly malpractice.
41 | TECHNOLOGY Saving the livers! New device prolongs viability of transplant organs.
46 | CLINICAL ANESTHESIOLOGY Streamlining surgery for patients on dialysis.
CME: PREANESTHETIC ASSESSMENT Lesson 305: PreAnesthetic Assessment of the Child Requiring Multiple Organ Transplantation, see page 47.
10 | Collaboration Between the Anesthesia and Surgical Teams in the Perioperative Setting