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 alarming sa...
Jul 01, 2025•16 min•Ep. 261
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 protoco...
Jun 24, 2025•30 min
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 complications • ...
Jun 17, 2025•18 min•Ep. 259
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 pressur...
Jun 10, 2025•16 min•Ep. 258
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 cla...
Jun 03, 2025•20 min•Ep. 257
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 un...
May 27, 2025•41 min•Ep. 256
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 medica...
May 20, 2025•27 min•Ep. 255
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 Anesthesia...
May 13, 2025•17 min•Ep. 254
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 monopolar...
May 06, 2025•20 min•Ep. 253
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 wit...
Apr 29, 2025•18 min•Ep. 252
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 labora...
Apr 22, 2025•16 min•Ep. 251
Sugammadex safety considerations span across patient populations with renal impairment, pediatric patients, and pregnant or breastfeeding individuals, requiring nuanced clinical decision-making based on current evidence and ongoing research. • Sugammadex reversal of moderate blockade is safe and faster than using neostigmine/cisatracurium for patients with renal impairment • Quantitative neuromuscular monitoring is essential to ensure adequate reversal (TOF >90%) • FDA approval exists for chi...
Apr 15, 2025•19 min•Ep. 250
Discover the critical safety considerations when using Sugammadex, the seemingly "magical" neuromuscular blockade reversal agent that's fundamentally changed anesthesia practice. We delve deep into the science behind this medication and examine its use in three challenging patient populations: those with renal failure, pregnant patients, and pediatric patients. For patients with kidney dysfunction, we explore the fascinating pharmacokinetics of Sugammadex and how its primarily renal excretion cr...
Apr 08, 2025•17 min•Ep. 249
Medication safety remains a cornerstone of anesthesia practice with complex environments and high-stakes decisions requiring vigilant attention to prevent errors. This collaboration between APSF and OpenAnesthesia spotlights critical aspects of perioperative drug safety with practical insights from Dr. Juan Li, a cardiothoracic anesthesia fellow at Beth Israel Deaconess Medical Center. • Perioperative anaphylaxis requires immediate recognition of cardiovascular, respiratory, and cutaneous manife...
Apr 01, 2025•17 min•Ep. 248
Climate change has arrived in the operating room, and pediatric anesthesiologists are taking action. Dr. Eva Lu-Boettcher, pediatric anesthesiologist and Director of Anesthesia Quality and Safety at the University of Wisconsin Children's Hospital, shares her journey toward sustainable anesthesia after witnessing firsthand the effects of climate change—including her Wisconsin community experiencing the world's worst air quality from wildfires. The healthcare sector contributes a staggering 8% of ...
Mar 25, 2025•14 min•Ep. 247
Dr. Liz Hansen takes us behind the scenes of a remarkable transformation at Seattle Children's Hospital, where pediatric anesthesiologists have reduced their greenhouse gas emissions by over 90% without compromising patient safety. A lifelong environmentalist and bike commuter, Dr. Hansen was shocked to discover that anesthesia gases contributed to 7% of her hospital's total emissions. This revelation sparked a personal and professional journey to align her clinical practice with her environment...
Mar 18, 2025•18 min•Ep. 246
In our latest episode, we dive headfirst into the growing issue of medical misinformation and its alarming effect on anesthesia patient safety. As patients increasingly turn to social media for health information, the risks of encountering inaccurate content have soared, posing challenges for healthcare professionals. Join us as we explore a recent article by George Tewfik and Raymond Malapero from the February 2025 APSF Newsletter, focusing on how misinformation can threaten patient safety, esp...
Mar 11, 2025•15 min•Ep. 245
Join us as we dive into the critical topic of medical misinformation and its alarming impact on patient safety, particularly in the field of anesthesia. In this compelling episode, we unpack how misconceptions shape patient trust and communication with healthcare providers. Our conversation features insightful commentary from Dr. George Tewfik, who highlights real-world examples of how misinformation spreads and influences patient decisions. The rapid rise of social media as a primary informatio...
Mar 04, 2025•15 min•Ep. 244
This episode delves into key findings in the literature, focusing on the nuances of neuromuscular blockade in pediatric patients and novel advancements in intubation techniques to enhance patient safety. We explore significant insights from recent studies that highlight age-related differences in recovery times from neuromuscular blockade and practical recommendations. We also discuss a novel flexible stylet for intubation and the implications of intravenous catheter design during emergency need...
Feb 25, 2025•17 min•Ep. 243
Feeling overwhelmed about staying up to date with the anesthesia literature? We hope you will check out the APSF's In The Literature section. This resource brings you straightforward summaries of recent high-impact articles related to anesthesia patient safety. This episode highlights crucial updates in the literature concerning diabetes management, the impact of fatigue on anesthesia professionals, research about GLP-1 receptor agonists, and the use of methadone for next-day discharge surgery. ...
Feb 18, 2025•20 min•Ep. 242
This episode discusses the implementation of ISO 80369-6 neuraxial connectors in Japan, analyzing the challenges faced and the implications for patient safety. The conversation highlights the importance of clinician involvement and the need for clear communication and trials during the transition to new medical standards. • Overview of ISO 80369-6 and its significance in anesthesia care • Challenges faced in Japan during the implementation of new connectors • Historical context of the LOR connec...
Feb 11, 2025•20 min•Ep. 241
The episode explores the challenges and lessons learned from Japan's recent implementation of ISO 80369-6 standards in anesthesia practices, highlighting the critical importance of clinician involvement in developing safety protocols. We discuss the historical context, issues with communication, and various complications arising from the transition to new safety standards. • Importance of ISO standards in enhancing patient safety • Role of clinician input in developing safety protocols • Japan's...
Feb 04, 2025•17 min•Ep. 240
Unlock the potential to save lives with our exciting discussion on the Anesthesia Patient Safety Foundation's Technology Education Initiative course. Featuring Dr. Michael Kazior, an esteemed anesthesiologist and intensivist, we spotlight the crucial skills of manual external defibrillation, cardioversion, and pacing. Dr. Kazior shares his personal journey and highlights the stark educational gaps in defibrillator usage among anesthesia professionals. This course, born from the collaboration bet...
Jan 28, 2025•13 min•Ep. 239
Can we significantly reduce pediatric medication errors in anesthesia care? This podcast episode explores the urgent need to address medication errors in pediatric anesthesia, highlighting effective strategies to improve patient safety. We discuss the implementation of tools such as the Anesthesia Medication Template, pre-filled syringes, and barcode scanning systems, as well as insights from experts on enhancing current practices. • Examination of medication error statistics in pediatric anesth...
Jan 21, 2025•15 min•Ep. 238
Unlock the secrets of preventing pediatric perioperative medication errors with insights from our esteemed guests, Eva Lu-Boettcher and Rahul Koka. Pediatric patients face unique challenges due to variations in body weight and dosing calculations, making them particularly vulnerable to medication errors. Join us as we explore the discrepancies between self-reported and observed error rates and gain a deeper understanding of the workflow vulnerabilities anesthesia professionals encounter. We also...
Jan 14, 2025•15 min•Ep. 237
What if a simple change in routine could save lives in the operating room? Join us as we explore this possibility with Jonathan Charnin, who shares his expertise and passion for improving hand hygiene practices in anesthesia. Hand hygiene may seem like a small detail, but it plays a crucial role in preventing the spread of pathogens and reducing surgical site infections. We'll unravel the complexities behind implementing effective hand hygiene protocols and discuss the obstacles and opportunitie...
Jan 07, 2025•18 min•Ep. 236
Join us on a fascinating exploration with Alli Bechtel, a dedicated anesthesiologist and the Anesthesia Patient Safety podcast host, who reveals the surprising journey from the United States to New Zealand in pursuit of a better work-life balance. Bechtel shares her unique insights into the supportive healthcare environment she found across the globe and the role of teamwork in ensuring patient safety in anesthesia. Her story provides a meaningful look at the personal and professional transition...
Dec 31, 2024•41 min•Ep. 235
What does it take to stay prepared for a rare but potentially life-threatening anesthesia complication like malignant hyperthermia (MH)? Join us as Dr. Henry Rosenberg, a trailblazer in the field and founder of the Malignant Hyperthermia Association of the United States, shares his insights on the evolution of MH diagnosis and management. We promise you'll gain a deeper understanding of the transition from traditional muscle biopsy contracture tests to cutting-edge DNA diagnostic methods. Prepar...
Dec 24, 2024•23 min•Ep. 234
Unlock the future of perioperative medicine with insights into remimazolam, the cutting-edge benzodiazepine poised to transform anesthesia practices. We uncover the remarkable features of remimazolam, from its rapid onset and short duration to its unique reversibility and minimal impact on cardiac and respiratory systems. Discover why this novel sedative is gaining traction for neurosurgery and neurology applications, especially for short procedures in the U.S. market. Explore the nuances of rem...
Dec 17, 2024•27 min•Ep. 233
What happens when a defective CO2 absorbent canister leads to ventilation failure during surgery? Our latest episode uncovers the hidden risks of hypoventilation and leaks in anesthesia machines following intra-procedure CO2 canister replacement. We discuss the critical role of manufacturers in providing warnings about potential equipment failures, the importance of backup systems, and the environmental considerations of CO2 absorbent usage and low flow anesthesia. By examining real-world scenar...
Dec 10, 2024•18 min•Ep. 232
