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The approximate incidence of substance abuse among CRNAs is
10%
What is the Council on Certification of Nurse Anesthetists responsible for?
Formulating and adopting requirements for certification and eligibility to take the NCE, administers the NCE, and evaluates the candidates performance on the NCE
Which perioperative event accounts for the greatest number of lawsuits?
Inadequate ventilation and oxygenation (usually from circuit disconnect)
The leading injury for which lawsuits are filed against anesthesia providers is?
Death
What does an occurence policy cover?
All claims arising during the policy period (even after the fact)
What does a claims made policy cover?
Only claims arising during the policy period; an additional "tail" is required to cover claims which fall outside of the policy period
What does umbrella coverage do?
Aids in paying a claim that exceeds the limits of the coverage on an existing policy
Who was the founder and first president of the AANA?
Agatha Hodgins
Define assault
A tort whereby a patient has a reasonable perception that battery is imminent
Define battery
A tort which results from the unconsented, harmful, offensive touching of another that actually results in injury
Who is referred to as the "Mother of Anesthesia"?
Alice Magaw
Which court case was the first to establish that nurse anesthetists may administer anesthesia without being guilty of the illegal practice of medicine?
Frank v. South
Which government agency was the first to make recommendations for universal precautions in 1988?
CDC
What is the most common barrier to investigation of a critical incident and the degree to which anesthesia equipment may have contributed?
Alteration of the equipment since the incident
Which statistical test presents data from two separate populations: those having a real procedure and those having a "sham" technique?
Pearson's chi-square test
The first direct-vision laryngoscope was devised in 1895 by?
Alfred Kirstein
Define sentinel event
Single, isolated event that may indicate a systemic problem; may or may not result in patient injury; requires a root cause analysis.
What is libel?
Malicious or negligently untruthful written statements, damaging or defamatory to an indivdual's reputation.

Slander is similar, only spoken, rather than written.
Summary statistics that reliably predict the central location for interval variables include?
Mean, median, and mode
What does the council for public interest in anesthesia do?
1.  Makes recommendations to the AANA on safety, quality of care, health care costs, and other issues
2.  Facilitates education to the public on issues regarding anesthesia care
3.  Facilitates communication among the public, health care professionals, and the nurse anesthesia profession
What is the principle of bodily integrity?
Patients have the final authority over what is done to them
What products will Jehovah's Witnesses not accept? Which products are suitable for administration?
PRBCs, FFP and platelets; Crystalloids, hetastarch and dextran

Albumin, erythropoietin (derived from abumin), immune globulins, and hemophiliac preparations are in a gray area (the individual must decide whether or not to consent)
Will Jehovah's Witnesses accept autologous blood?
No. Blood salvaging or normovolemic hemodilution may be acceptable, but only if the blood maintains continuity with their circulatory system at all times.
Are most preventable mishaps in anesthesia due to human error or equipment malfunction?
Human error
Which standard monitors were believed to have reduced the incidence of adverse respiratory events?
Pulse oximetry and capnography
Many anesthetic fatalities are associated with what chain of events?
The mishap chain: Coincidental circumstances, misjudgments, and technical errors
Which is more common during anaphylactic reactions under anesthesia, cardiovascular and cutaneous manifestations or bronchospasm?
Cardiovascular and cutaneous manifestations
Which is more common, anaphylaxis or anaphylactoid reactions?
Anaphylactoid reactions (both are equally life-threatening)
What are the most common causes of anaphylaxis during anesthesia?
1.  Muscle relaxants
2.  Latex
What should you suspect in patients with spinal cord injury, spina bifida, or congenital abnormalities of the GU tract?
Latex allergy
What are the maximum acceptable trace concentrations of exposure to volatile anesthetics set forth by OSHA?
N20 < 25 ppm and < 0.5 ppm for halogenated agents
< 2 ppm for halogenated agents alone  
Anesthesiology is a high-risk medical specialty for?
Drug addiction
What are the two most important methods of minimizing radiation exposure?
Using proper barriers and maximizing one's distance from the source
What are the most common human errors leading to preventable anesthetic accidents?
1.  Unrecognized breathing circuit disconnection
2.  Mistaken drug administration
3.  Airway mismanagement
4.  Anesthetic machine misuse
5.  Fluid mismanagement
6.  Intravenous line disconnection
What are the most common equipment malfunctions leading to preventable anesthetic accidents?
1.  Breathing circuits
2.  Monitoring devices
3.  Ventilator
4.  Anesthesia machine
5.  Laryngoscope
What factors are associated with human error and equipment misuse?
1.  Inadequate preparation (no machine checkout or preoperative evaluation; haste and carelessness)
2.  Inadequate experience and training (unfamiliarity with anesthetic technique or equipment)
3.  Environmental limitations (inability to visualize surgical field; poor communication with surgeons)
4.  Physical and emotional factors (fatigue; personal problems)
What may pronation of the forearm cause?
External compression of the ulnar nerve in the cubital tunnel.
What are common documentation pitfalls to avoid?
1.  Completing entries for events prior to when they occur.
2.  Incomplete descriptions of procedures or management.
3.  Inaccurate or conflicting times between different records.
4.  Lost critical patient data.
5.  Incomplete or poorly thought-out notes following an adverse event.
6.  Signing inaccurate documents or documents without reading them.
7.  Failure to document meetings with patients/family, leaving open the possibility of conflicting recollections.
8.  Failure to obtain supporting documentation from others.
What are Type I hypersensitivity reactions?
Immediate:
Atopy
Urticaria - angioedema
Anaphylaxis
What are Type II hypersensitivity reactions?
Cytotoxic:
Hemolytic transfusion reactions
Autoimmune hemolytic anemia
Heparin-induced thrombocytopenia
What are Type III hypersensitivity reactions?
Immune complex:
Arthus reaction
Serum sickness
Acute hypersensitivity pneumonitis
What are Type IV hypersensitivity reactions?
Delayed, cell-mediated:
Contact dermatitis
Tuberculin-type hypersensitivity
Chronic hypersensitivity pneumonitis
Allergic sensitivity to drugs and other allergens is mediated by?
IgE
In allergic drug reaction, what does prednisone block?
Mitosis
In allergic drug reaction, what does antihistamine partially block?
Smooth muscle and other end organ effects of histamine, kinins, leukotrienes (SRS), prostaglandins, serotonin, and platelet activating factor
In allergic drug reaction, what can block degranulation and mediator release?
Isoproterenol, theophylline, epinephrine, and cromolyn (partially)
What are the clinical manifestations of anaphylaxis?
CV: Hypotension, tachycardia, arrhythmias
Resp: Bronchospasm, cough, dyspnea, pulmonary edema, laryngeal edema, hypoxia
Dermatological: Urticaria, facial edema, pruritis

Bold = seen during GA  
How do anaphylactoid reactions differ from anaphylaxis?
They do not depend on IgE antibody interaction with antigen.  A drug may directly release histamine from mast cells (urticaria following high-dose morphine)
What is anaphylaxis?
An exaggerated response to an allergen (antibiotic) that is mediated by a type I hypersensitivity reaction
What are the causes of anaphylactic reaction?
Against polypeptides:
Venoms (Hymenoptera, fire ant, snake, jellyfish)
Airborne (Pollen, molds, danders)
Foods (Peanuts, milk, eggs, seafood, grain)
Enzymes (Trypsin, streptokinase, chymopapain, asparaginase)
Heterologous serum (Tetanus, antilymphocyte globulin, antivenin)
Human proteins (Insulin, corticotropin, vasopressin, serum and seminal proteins)
Latex
Against hapten carriers:
Antibiotics (Penicillins, cephalosporins, sulfonamides)
Disinfectants (Ethylene oxide, chlorhexidine)
Local anesthetics (procaine)
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