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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.8K
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
658
General Anesthesia: Overview01:24

General Anesthesia: Overview

533
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
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Using Evidence-Based Best Practices of Simulation, Checklists, Deliberate Practice, and Debriefing to Develop and

Laura Lee Wiggins1, Suzanne Morrison2, Calvin Lutz3

  • 1has been the program director for the Nurse Anesthesia Regional Anesthesia Training Course at the Peter M. Winter Institute for Simulation, Education, and Research in Pittsburgh, Pennsylvania, since 2013. She also is the chief nurse in charge of education and training at the 911th Aeromedical Staging Squadron at the Pittsburgh International Airport Air Force Reserve Station, Pittsburgh.

AANA Journal
|October 2, 2019
PubMed
Summary

A new blended-learning curriculum effectively improved Certified Registered Nurse Anesthetists' (CRNAs) knowledge and confidence in regional anesthesia. This training pathway helps CRNAs expand their practice scope to include these vital skills.

Keywords:
Checklistsdeliberate practiceepidural anesthesiasimulationspinal anesthesia

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Area of Science:

  • Anesthesiology
  • Nursing Education
  • Medical Simulation

Background:

  • The Institute of Medicine (2011) recommended nurses practice to their full scope.
  • Anesthesia practice models have limited Certified Registered Nurse Anesthetists (CRNAs) in regional anesthesia.
  • Evolving practice models and skill maintenance needs necessitate expanded CRNA scope.

Purpose of the Study:

  • To evaluate a blended-learning curriculum for regional anesthesia training.
  • To assess the curriculum's impact on CRNA knowledge, skills, and attitudes.
  • To establish a clinical credentialing pathway for regional anesthesia administration.

Main Methods:

  • A quality improvement project utilized a blended-learning curriculum.
  • Deliberate practice and validated checklists were incorporated for skill development.
  • Forty-nine CRNAs completed the training and met skill thresholds.

Main Results:

  • Significant gains in CRNA knowledge were observed.
  • CRNA confidence levels in regional anesthesia administration significantly increased.
  • The curriculum facilitated skill acquisition within a credentialing pathway.

Conclusions:

  • Blended-learning simulation is effective for CRNA regional anesthesia training.
  • The curriculum successfully augmented CRNA knowledge and confidence.
  • This approach supports CRNAs in expanding their practice scope to include regional anesthesia.