Good communication is a hallmark of medicine that has spanned centuries, colloquialized into the physician’s “bedside manner” which patients and their families value dearly. Indeed, having this skill can certainly facilitate the smooth incorporation of modern medicinal science into personalized care and understanding for an individual patient. As anesthesiologists, we understand the value of this element in our profession. We work to build rapport with our patients, often in the acute perioperative setting, without the benefit of having … [Read More...]
Main Content
Presidents’ Messages
Patient Safety at the Forefront of Anesthesiology
By Marie Sankaran Raval, MD
VSA President
Assistant Professor of Anesthesiology Division of Pediatric Anesthesiology
VCU Health System, Richmond, VA
Since moving to Richmond in 2012, the VSA has played an integral role in my professional career and I am so excited to serve as your next VSA President. As a pediatric anesthesiologist at the Children’s Hospital of Richmond, I have seen firsthand the incredible power of working together and advocating for issues that affect our specialty and the practice of medicine. I have gained a huge sense of community and have witnessed the power of advocacy as we have gained headway in various legislative topics, including defeating the repeal of the … [Read More...]
Physician Anesthesiologists and the Quadruple Aim
By Jeffrey Green, MD, FASA
VSA Immediate Past President
Boyan-Keenan Professor of Anesthesia Safety
VCU Health System, Richmond, VA
At the VSA membership meeting on February 2, I had the pleasure of handing over the gavel to the new VSA President, Dr. Marie Sankaran Raval and presiding over the election of your new officers, directors, delegates and alternates. I couldn’t be more excited for the future of the VSA with this new group of outstanding leaders. I can’t help but think about some of the former physician anesthesiologist leaders in Virginia and their connections to the theme of the current newsletter. For example, former Chairs of the VCU Department of … [Read More...]
Opinion
Some Thoughts on the Education of Patients
By Lynda T. Wells, MBBS, FRCA
Associate Professor of Anesthesiology
University of Virginia, Charlottesville, VA
In medical school, I learned never to assume that the patient knew anything about human biology. To illustrate this, we were shown the results of a sociology project conducted on a random sample of the general, adult population. They had been asked to shade in where the kidneys were on an outline of the human form. The variation in the responses was huge, including about 10% of respondents who drew kidneys in the scrotum. The professor leading the class asked “What do you think it would mean to a woman who believed kidneys were in the … [Read More...]
Theme – Patient Safety & Education
Medical Simulation in Anesthesia Residency Training
By Michael S. Czekajlo, MD, PhD; Michael Kazior, MD; and Paras Shah, DO, MPT
CVHCS, Richmond, VA
Introduction Medical simulation has been demonstrated to be an effective method for education. (1,2) Since the creation of the first simulator in the 1960’s, the technology has developed and allows for mastery of learning of skills to the simulation of simple to complex clinical scenarios on high fidelity simulators. More recently simulation is … [Read More...]
Adults as Learners
By Mark T. Nelson MD, MEd
VCU Health Systems, Richmond, VA
and Jean Bailey, PhD
VCU School of Medicine, Richmond, VA
When we think of learners, K-12 students usually come to mind. Most of us remember those days well. As we have grown though, we began to see, experience, and value education differently. Almost without our knowing it, we transitioned from child to adult, becoming adult learners. Adult learners (described by studies from the perspective of … [Read More...]
Safe Perioperative Pathways for Balancing OSA and Ambulatory Surgery
By Alexander J. Skojec, MD
Anesthesia Resident, Department of Anesthesiology
University of Virginia, Charlottesville, VA
Long lauded as proponents of patient safety, and increasingly so in perioperative medicine, Anesthesiologists exert an invaluable impact on the perioperative management of patients with obstructive sleep apnea (OSA). While the prevalence of OSA and OSA-related diseases (e.g. hypertension and obesity) surge in the United States, anesthesiologists … [Read More...]
Implementation of Delirium Screening in Intensive Care Unit Patients
By Michael Kazior, MD
Assistant Professor of Anesthesiology
CVHCS, Richmond, VA
and Daniel H. Gouger, MD
Anesthesia Resident, Department of Anesthesiology
VCU Health System, Richmond, VA
Anyone who has ever worked in the intensive care unit likely has memories of a delirious patient. This patient probably had active hallucinations, restraints due to violent behavior, and didn’t recognize loved ones or their current surroundings. This is also the most common depiction seen in the mainstream media on television and movies, however, … [Read More...]
Anesthesiologists and Serious Illness Discussions in the COVID-19 Pandemic
By Vishal Yajnik, MD, MS
Assistant Professor of Anesthesiology
Division of Critical Care
VCU Health System, Richmond, VA
Good communication is a hallmark of medicine that has spanned centuries, colloquialized into the physician’s “bedside manner” which patients and their families value dearly. Indeed, having this skill can certainly facilitate the smooth incorporation of modern medicinal science into personalized care and understanding for an individual … [Read More...]
Practice Spotlight
The Airway Alert: A Multi-Disciplinary Approach to Management of The Difficult Airway
By Maxine Lee, MD, MBA, FASA
VSA Past-president
Partner, Anesthesiology Consultants of Virginia, Roanoke, VA
Carilion Roanoke Memorial Hospital is Carilion Clinic’s flagship hospital. It is an 850-bed, tertiary referral center with a one million-patient catchment area and a Level I Trauma Center. As such, it gets its fair share of bad airways – trauma, angioedema, morbid obesity, head and neck cancers, etc. Airway management is performed by various specialties throughout the hospital. Intubations in the ED are performed by the EM physicians. Intubations in the in-patient setting, in addition to anesthesiologists, are performed by various services … [Read More...]
Medical Student Article
Perspective on the Introduction of Pharmacy to a Pre-Operative Anesthesia Clinic
By Karishma Popli, BS, MBE
Third Year Medical Student
Medication errors account for more than 400,000 in-hospital adverse drug events in the United States each year, costing the healthcare system over $3 billion annually1. Over 60% of patients being admitted have at least one medication omission or error, with approximately 11-59% of these errors having the potential to cause harm or an adverse drug … [Read More...]
Abstract
Improving Breast Brachytherapy Perioperative Course with Erector Spinae Plane Blocks
By Yvonne Nguyen, MD; Jialiu Li, MD; Micheal Buxhoeveden, MD; and Sabrina Dhillon, MD
Anesthesia Resident(s) Department of Anesthesiology
VCU Health System, Richmond, VA
Introduction Breast cancer is the leading cause of both cancer and cancer-related death in females in the United States [1]. Breast brachytherapy has emerged as an adjunct and monotherapy in this population. Studies have found improved outcomes with adjuvant brachytherapy with decreased mortality and reduction in recurrence [2, 3]. With the … [Read More...]
Members in the News
Anesthesiologist Dr. Michelle Lynam Wins Dr. USA Pageant
VSA Member Michelle Lynam, MD, of Commonwealth Anesthesia Associates in Richmond, won the title of Dr. United States of America for 2021. Dr. Lynam had never entered a pageant before but was inspired by the message of this pageant: “Smart is Beautiful”. The organization focuses on education, mentoring and community service. Her platform is … [Read More...]
Meetings
Annual VSA Meeting Recap
By Casey Dowling, DO, FASA
VSA Treasurer
Medical Director S.T.A.R.T. Clinic
Winchester Anesthesiologists, Inc., Winchester, VA
On February 2, 2021 the Virginia Society of Anesthesiologists had its Annual Membership Meeting. Unlike previous years, but very much like all meetings held during the previous year, our meeting was held virtually. I am happy to report that almost 70 members tuned in! Dr. Jeff Green addressed the group and reviewed the activities of his 2-year … [Read More...]
Legislative News
Meet Your Legislator: Delegate Schuyler VanValkenburg
72nd District • History and Civics Teacher at Glen Allen High School This last year has posed unusual and enormous challenges to education policy here in Virginia, as the readers of this journal are undoubtedly and sadly very aware. School nurses and health care practitioners have been heroes in both the school-specific problems we face and, … [Read More...]
2021’s Virtual Legislative Session was Successful
By Lauren Schmitt
Commonwealth Strategy Group
The 2021 Virginia General Assembly session officially came to an end on March 1. Despite the challenges of a virtual session and not being able to communicate face-to-face with legislators, it was still a very successful legislative session for us. We were able to defeat a number of bills that would’ve been harmful to the House of Medicine. Our … [Read More...]