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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • S e p t e m b e r 2 0 1 3 • Volume 39 Number 9
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Prehospital Aspiration Ups Pneumonia Risk
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ne of the deadliest types of hospital-acquired infections in adult trauma patients is set in motion long before patients arrive at the hospital, according to a study reported at the 2013 meeting of the Surgical Infection Society. A study involving surgeons and paramedics showed that trauma patients who aspirate before they get to the hospital have a fourfold increased risk for developing health he care–associated pneumoonia (HCAP) and a more th han threefold increased risk for ventilator-associated pneumonia (VAP). In many cases, patients aaspirate prior to interventions by paramedics, suggesting that a key
ICD-10 Ch Risks and For Anest
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astering the ICD D-10 coding transition to optimize reimbursemeent for anesthesia services will take an effort, but it can pay off in terms of higher practice revenue, lesss paperwork and greater overall clinical efficiency, expperts said. Although full implementtation of the new International Classification of Diseases (ICD) system is plann ned for October 2014, a lot needs to happen before then, according to the Centers for Medicare & Medicaid Services (CMS). The ageency’s timeline stipulates that
see aspiration page 21
see coding page 10
Anesthesiologists Sometimes Fall Short of Team Needs: Report
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nesthesiologists believe they know what qualUnited Kingdom, who conducted the survey. “We need to focus on the things ities are most important for them to cultivate: competency and others need from us to be a better calmness under pressure, for instance. player, and try to adapt. We’re not sole physicians; we work with othBut a new study has found that practitioners with whom anesthesiologists ers in a team. And the best patient care frequently work often have much comes from those of us that provide the different opinions about what they best teamworking environment.” should deliver—suggesting anestheDr. Petsas and her co-author, Sally siologists may not always be meeting Ann Shiels, BMBCh—both based at the the needs of their team. Oxford Deanery in England—surveyed 130 surgi“There are lots of things we think are cal clinicians at two U.K. hospitals. Participants were important that others don’t,” said Anna Petsas, MBBS, anesthesiologists, operating department practitioners, a fellow of the Royal College of Anaesthetists in the see team needs page 30
NEW PRODUCTS see pages 9 and 13
see pages 17 and 31
see page 30
Warming System, from Stryker
Anesthesia Touch, from Plexus Information Systems, Inc.
FORE-SIGHT Elite™, from CAS Medical Systems Inc
08 COMMENTARY An anesthesiologist’s guide to medical history.
17 TECHNOLOGY Personal CPAP machines offer uncertain benefit for hospitalized patients.
23 CLINICAL ANESTHESIOLOGY Type of loop diuretic influences morbidity, mortality after cardiac surgery.
26 PAIN MEDICINE AMA resolution on pain drugs roils pharmacists.