What Is Neuromuscular Electrical Stimulation?

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

(History of Nurse Anesthesia Practice. 2010, May), (Koch, E., Downey, P., Kelly, J. W., & Wilson, W. 2001).

The discharge criteria in the policy states the patient will be fully awake, vital signs stable, no nausea or vomiting, and the patient is able to void. All practitioners that provide moderate sedation must complete a training module prior to providing moderate sedation, this includes personnel assisting with the procedure. The first process failure was not meeting the required monitoring of the patient as mandated by the moderate sedation policy. In the absence of ECG or respiratory monitoring the sedation administered produced apnea then asystole without ED personnel being aware of acute changes in the patient’s condition. There is no explanation for why the patient was not on continuous ECG monitoring. Equipment was found to be in good working order.

The need for monitored anesthesia care depends your procedure, your condition, and the potential need for regional or general anesthesia. It is often provided during procedures where:

sedation have continuous BP, ECG, & Pox monitoring done. Nurse J. who was trained in the

The first assessment of CB in the PACU revealed that she was still deeply sedated. The anesthesiologist almost had to administer Narcan to reverse her anesthesia because she was having such a difficult time waking up. She had clear breath sounds bilaterally and her skin was warm to the touch. Her initial blood pressure reading was 134/72. Her bladder was non-distended and her pain rating was 9/10 in her abdomen. An IV push of 2 grams of Dilaudid was given for her pain. Additionally CB was given Zofran for nausea. Specifically in the PACU the nurses are monitoring the patient’s airway, their pain, level of consciousness, any bleeding at the incision site, and nausea. CB was kept in the PACU, or stage I as it is referred to in the Surgery Center, for an hour until she was alert and able to breath on her own without a nonrebreather mask. Every patient is put on a nonrebreather and EKG when they arrive in stage I. Vitals are taken every five minutes times four, then once before they leave. There is a specific documentation

The anesthetist assessed the patient’s vitals by comparing the values to what is normal and what was normal for the patient when it was measured at the beginning of anesthesia. The vitals were taken every 10 minutes with a blood gas analysis performed every 30 minutes to monitor the electrolytes. These parameters would not only help to maintain the patient at a surgical plane of anesthesia but also help the anesthetist maintain the patient at a steady state physiologically and metabolically. In addition, the patient’s potassium levels were specially monitored throughout the anesthesia due to his HYPP status. An arterial catheter would also be placed in the patient’s metatarsal artery for measurement of direct blood pressure and would also be used for blood collection for IRMA blood gas

warms up the muscles without causing fatigue to other body systems (DJO Global Inc., 2017).

This technology is the same as that used for dorsal column stimulation which has been validated for for chronic pain syndrome, failed back syndrome and peripheral neuropathic pain[5]. The pilot study is being performed at the Cleveland Clinic for DBS[6]. Studies have been performed for motor cortical stimulation[7]. Results are variable but promising. Technique varies from institution to institution and a consensus is yet to be reached . Given the dire nature of intractable neuropathic face pain, the lack of effective therapy and reported efficacy of neuromodulation surgery, it is reasonable to offer DBS or MCS in carefully chosen

Anesthesiologist often have busy schedules filled wit long days. Some of their duties include, of course, administering the anesthetic along with

Mr. B.’s procedure after sedation (was accomplished) was successful and his sedation level continues. Nurse J then applies an automatic blood pressure machine to measure every 5 minutes and a pulse oximeter, however the nurse does not apply any respiratory monitor or heart monitor which are protocol after a sedation procedure. The nurse then rushes out of the room leaving Mr. B. with his son with no medical personnel at the bedside to monitor the patient. No sedation score or neurological assessment of Mr. B. is noted, which should be performed after any procedure including sedation. This data is either missing, not documented or not performed by Nurse J. Mr. B.’s alarm for low saturation is alarming and the LPN enters the room briefly,

Once stage one of the WHO checklist had been completed by the anaesthetic ODP and the Operating Surgeon had signed his part of stage one, in accordance with minimal monitoring standards set by the Association of Anaesthetists of

(1) The animal shows no improvement in health and is expected due to illness or injury to be in pain/stress until death

The government should not allow pharmaceutical companies to use animals in testing because drugs tested on animals often don’t instigate the desired effect on humans and alternative methods of

This procedure is generally done once the patient is asleep, as that is least stressful on the patient. It is important to explain to the patient that when they were given the medication to put them to sleep, their brain was unconscious and therefore the desire to breathe was interrupted (Ignatavicius & Workman, 2013). It is also important to explain to the patient, if they want to know, the roles of the workers in the operating room. Each operating room has an anesthesiologist as well as a nurse anesthetist. The nurse anesthetist monitors the patient’s vitals during the procedure, therefore this person is making sure that the amount of medication is right, as well as making sure that the oxygen levels are within an acceptable range (Glick,