Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultura...
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Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultura...
Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultura...
Maternal care is at a breaking point: delivering hospitals are disappearing while deaths that could be prevented keep climbing. We pull back the curtain on how structural racism, policy headwinds, and technology blind spots compound risk for birthing people—especially Black, Hispanic, rural, and low‑income patients—and what it takes to change the trajectory now. We start by naming the problem with data: stable birth rates alongside a steep decline in maternity units have created care deserts...
Welcome back to our 2025 Stoelting Conference Podcast Series. Fever isn’t the fail-safe it’s made out to be—especially in pregnancy. We walk through the subtle ways maternal sepsis hides in plain sight, why a quarter of those who died never had a fever, and how early warning tools, rapid antibiotics, and source control change the odds. From there, we pivot to maternal hemorrhage and show how quantifying blood loss with calibrated drapes plus a treatment bundle outperforms the old habit ...
Maternal safety changes when we stop relying on heroics and start building systems. We open the door to the 2025 APSF Stolting Conference series with a fast, practical tour of what truly reduces morbidity and mortality: collaboration across anesthesia, obstetrics, cardiology, and nursing; open‑source AIM bundles; early warning tools; and standards that compress time-to-treatment when minutes matter. Along the way, we confront the three deadly D’s—denial, delay, dismissal—and replace them with...
A patient rolls into the OR with a tracheostomy—do you maintain the current tube, intubate orally, or go through the stoma? We break down the decision tree that keeps patients safe, from assessing tract maturity and surgical needs to choosing cuffed vs uncuffed strategies and planning for positive pressure ventilation. Then we shift to a critical safety pivot: total laryngectomy. When the trachea is sutured to the skin, the mouth and nose no longer connect to the lungs, and attempts at oral i...
Tracheostomy complications occur at an alarming rate, affecting nearly half of all patients during their initial hospitalization. When these emergencies strike, having a systematic approach can make the difference between life and death. We dive deep into the critical steps for managing a malfunctioning tracheostomy, beginning with immediate actions like cuff deflation and rapid information gathering about the tracheostomy's history. You'll learn how to systematically troubleshoot ventilatio...
When our smallest patients need anesthesia care, their immature systems present unique challenges that demand specialized knowledge and vigilance. The risk of postoperative apnea in former preterm infants has long been recognized, but the evidence guiding management continues to evolve. Join Dr. Alli Bechtel and pediatric anesthesiologist, Dr. Eva Lu-Boettcher as they explore the physiological vulnerabilities that make premature infants susceptible to respiratory complications after anesthes...
Could your CO2 sensor be putting patients at risk? This eye-opening Rapid Response to Questions from our Readers episode explores a serious patient safety concern that every anesthesia professional needs to understand. We dive into two troubling cases where patients under general anesthesia developed respiratory acidosis despite normal-appearing monitoring parameters. The culprit? A semi-quantitative CO2 sensor being used in an operating room setting where it was never designed to function s...
Patient engagement stands as the cornerstone of perioperative safety, bringing together the knowledge of medical professionals with the lived experiences of those receiving care. Through powerful personal testimonies and expert insights, we explore how this critical partnership transforms surgical outcomes. Vonda Vaden Bates shares her heartbreaking journey that began with her husband's successful brain surgery but ended tragically with a fatal pulmonary embolism. Despite their active engage...
What happens when we truly listen to patients' fears about anesthesia? The Anesthesia Patient Safety Foundation (APSF) discovered something remarkable: despite the wealth of medical information available, patients' most pressing questions about anesthesia remained largely unanswered in accessible language. This episode delves into the groundbreaking work of the APSF Patient Engagement Workgroup, featuring insights from Maria Van Pelt. We explore how this initiative transformed patient concer...
Every anesthesia professional has encountered IV infiltration—but when neuromuscular blocking agents are involved, this common complication becomes a complex patient safety challenge with no established guidelines. This episode delves into the critical management of infiltrated paralytics, a complication affecting 14% of peripheral IV catheterizations that can lead to delayed induction, compromised emergence, and potentially serious tissue injury. We're joined by Dr. Govind Rangrass, Profess...
Ever wondered what happens when neuromuscular blocking agents infiltrate into surrounding tissue instead of flowing smoothly through an IV? The consequences can be serious and potentially life-threatening for patients recovering from anesthesia. We dive deep into a complication that affects nearly 14% of the 150 million peripheral IV catheter insertions performed annually in the United States. While most healthcare providers have experienced IV infiltrations, few understand the unique danger...
Navigating the fine line between effective pain control and minimizing harm from opioid medications remains one of anesthesiology's greatest challenges. This episode dives deep into the evolving landscape of perioperative pain management, examining how clinicians can achieve the delicate balance required for optimal patient outcomes. Dr. Paul Guillod joins us to share his perspective as both an anesthesiologist and pain management specialist, highlighting how opioid-sparing techniques create...
Perioperative stroke represents a rare but potentially devastating complication of anesthesia care. While occurring in less than 1% of non-cardiac surgical patients, this complication fundamentally threatens not just patient outcomes but their very identity. As Dr. Jacob Nadler poignantly notes in our podcast, "By maintaining brain health, we're preserving the essence of who our patients are—their memories, their personality, their ability to connect with friends and family." The most signif...
A revolution in pain management has arrived. The FDA's approval of Suzetrigine in January 2025 introduces the first non-opioid analgesic for moderate to severe pain in over twenty years. This breakthrough medication targets the voltage-gated sodium channel, NAV1.8, effectively blocking pain signals at their source before they reach the brain. What makes Suzetrigine remarkable is its precision. With over 30,000-fold selectivity for NAV1.8 channels, it delivers powerful analgesia without affec...
Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care. The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic...
The standard of care for monitoring blood pressure during surgery hasn't changed in nearly 40 years, despite technological advances that could prevent serious complications and save lives. This eye-opening episode takes listeners inside a recent Capitol Hill briefing where healthcare professionals, lawmakers, and patient safety advocates made the case for continuous blood pressure monitoring as a critical patient safety measure. Alarming statistics frame the urgency of this issue: one in nin...
Ready for a refreshing summer dive into the latest anesthesia safety research? This episode explores three groundbreaking studies that could transform perioperative practice and patient outcomes. First, we examine a fascinating randomized clinical trial on "just-in-time" training for inexperienced clinicians performing infant intubations. The results are impressive: trainees who received just 10 minutes of structured training immediately before the procedure achieved a 91.4% first-attempt su...
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 alarmin...
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 pro...
Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultura...
