Anesthesia Patient Safety Podcast

#300 Pro-Social Teams: Safer, Faster, Kinder

The fastest way to make an operating room feel unsafe isn’t a broken monitor, it’s a team that stops acting like a team. We dig into pro-social behavior: the small, voluntary actions that support other people and the group, including kindness, cooperation, and gratitude, and why these behaviors can lower cognitive load, strengthen communication, and improve anesthesia patient safety when the schedule gets tight and the stakes are high. We share highlights from the February 2026 APSF Newsletter feature “Reduce Burnout, Improve Safety and Efficiency: Consider Pro-Social Behavior,” with insights from APSF leader Jeffrey Feldman. He connects persistent preventable harm and rising clinician burnout to the day-to-day culture in perioperative care, where interactions can become impersonal and inconsistent under production pressure. A vivid OR scenario brings it to life: a difficult airway, staffing constraints, unfamiliar teammates, and the clock driving tension instead of coordination. We also hear from Caoimhe Duffy, whose work in human factors and teamwork focuses on the “everyday actions” that keep patients safe before harm occurs. Her goal is practical: make positive behaviors more visible, more measurable, and easier to teach so teams can improve clinician well-being and patient safety at the same time. We close with a teaser for what’s next, including Elinor Ostrom's Nobel Prize-winning framework for collaboration and how it could offer an out-of-the-box model for building stronger perioperative teams. Subscribe so you don’t miss part two, share this with a colleague who’s feeling the pressure, and leave a review to help more clinicians find the show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/300-pro-social-teams-safer-faster-kinder/ [https://www.apsf.org/podcast/300-pro-social-teams-safer-faster-kinder/] © 2026, The Anesthesia Patient Safety Foundation

#299 Cannabis And Anesthesia

Cannabis has gone mainstream, but perioperative risk has not improved. THC products are far more potent than they were decades ago, emergency room visits are climbing, and many patients still walk into surgery thinking that it’s safe. We want anesthesia professionals to have a clearer, evidence-informed way to think about cannabis and anesthesia before the next case.  We open the latest APSF newsletter feature article, “Cannabis and Anesthesia,” and bring in author Trisha Meyer to frame why this topic matters now. Together, we walk through the pharmacology that shows up at the bedside: THC vs CBD, CB1 and CB2 receptors, the endocannabinoid system, and how route of use changes onset and duration. Then we get practical about drug-drug interactions and highlight a free interaction-checking resource you can use in real time. From there, we map cannabis use across the perioperative timeline. Preop means asking better questions and documenting details like product type, dose, frequency, last use, and withdrawal symptoms, plus knowing when intoxication should delay elective surgery and when cardiac risk may need more workup. Intraop means expecting possible higher propofol and sedative requirements, watching for cardiovascular instability, and preparing for airway hyperreactivity and bronchospasm in inhaled users. Postop means planning for higher pain needs, using multimodal analgesia, and recognizing withdrawal, hypothermia, and shivering patterns that can surprise teams. If you care about perioperative patient safety, listen, share this with a colleague, and subscribe so you don’t miss what’s next. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/299-cannabis-and-anesthesia/ [https://www.apsf.org/podcast/299-cannabis-and-anesthesia/] © 2026, The Anesthesia Patient Safety Foundation

#298 New APSF Brain Health Guidance For Older Adults

Postoperative delirium is one of the most common adverse events after surgery for older adults, and it can change a patient’s recovery, independence, and quality of life. We take a practical, evidence-focused look at what anesthesia teams can actually do to support perioperative brain health, using the latest recommendations from the APSF Brain Health Patient Safety Advisory Group. We walk through the four questions clinicians keep asking at the bedside. First, does intraoperative hypotension drive delirium? We break down why the data is mixed, what mechanisms make hypotension plausible, and why individualized hemodynamic goals with rapid correction still belong in a modern patient safety strategy. Next, we tackle benzodiazepines and the Beers Criteria: newer trials and practice advisories suggest short-acting agents like midazolam and ultra-short-acting options like remimazolam do not need to be avoided solely to prevent postoperative delirium, while medication review, deprescribing, and cognitive screening remain essential. From there, we get into anesthetic depth and intraoperative EEG monitoring. EEG guidance can reduce burst suppression and may help tailor dosing as part of precision anesthesia, but the evidence is still inconclusive on whether it prevents delirium in older adults. We close with the long-debated choice between general anesthesia and regional anesthesia, highlighting recent meta-analyses and trials showing no significant difference in delirium incidence once confounders are controlled, with a key nuance around avoiding excessive sedation. Subscribe for more anesthesia patient safety updates, share this with a colleague, and leave a review if the conversation helps you bring a brain health lens to your next case. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/298-new-apsf-brain-health-guidance-for-older-adults/ [https://www.apsf.org/podcast/298-new-apsf-brain-health-guidance-for-older-adults/] © 2026, The Anesthesia Patient Safety Foundation

#297 From OR To ICU: How Checklists And Clean Hands Save Lives

Transfers don’t have to feel like controlled chaos. We break down how to move a critically ill patient from the OR to the ICU with confidence by pairing structured handoffs with disciplined infection prevention—so information moves seamlessly while pathogens hit a dead end. We start by revisiting the ICU’s influence on anesthesia practice through the story of ARDS and lung-protective ventilation. The shift to 6 ml/kg ideal body weight didn’t just save lungs in the unit; it reshaped intraoperative strategy to reduce ventilator-induced injury for surgical patients. From there, we zoom into the human factors of handoffs: why complex, time-sensitive details—hemodynamics, antimicrobials, ventilator settings, imaging, and goals of care—so often fall through the cracks, and how IPASS, OR-to-ICU structured handoffs, and explicit role assignments align teams.  Then we tackle pathogen transmission where it thrives: device-rich environments and high-touch surfaces. We unpack how environmental reservoirs and biofilms turn bed rails and anesthesia machine into unseen vectors, and why consistent, high-frequency hand hygiene is the most powerful countermeasure. Clear targets make habits stick: at least four sanitizer uses per hour in the ICU and eight per hour in the OR, coupled with strict isolation adherence and diligent decontamination.  By the end, you’ll have a tight, transferable playbook: adopt lung-protective settings across care areas, script handoffs with shared tools and timed calls, measure sanitizer touches, and treat the environment as a clinical variable. If this conversation helps your team cut errors or infections, share it with a colleague, subscribe for future episodes, and leave a review with one change you’ll make this week. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/297-from-or-to-icu-how-checklists-and-clean-hands-save-lives/ [https://www.apsf.org/podcast/297-from-or-to-icu-how-checklists-and-clean-hands-save-lives/] © 2026, The Anesthesia Patient Safety Foundation

#296 How We Build Safer Anesthesia Teams, One Trainee At A Time

A small air bubble, a missed monitor cue, a late call for help—tiny moments that can change everything. We sit down with Dr. Max Feinstein to unpack how real-world anesthesia education builds safer clinicians, why attention is our most precious resource, and how culture—not heroics—prevents harm. From clear talk about morbidity and mortality to practical tactics like just-in-time simulation and curated literature, we map out a grounded approach to training that sticks under pressure. For new attendings, the leap to autonomy can feel surreal. We talk through imposter syndrome, the virtue of asking for help early, and how to choose a practice that backs safety over production pressure. Want red flags? Proceeding with non-NPO patients or brushing off new chest pain are hard stops. You’ll also hear about Dr. Feinstein’s current research in blood and transfusion management for cardiac surgery, his YouTube channel that demystifies anesthesia for learners and patients, and a nonprofit close to his heart, Heart Care International, supporting care for kids with congenital heart disease. If you care about anesthesia safety, team culture, and teaching that actually changes behavior, this conversation will give you tools you can use on your next case. Subscribe, share with a colleague who mentors trainees, and leave a review with your top strategy for reducing OR distractions—what works best for your team? For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/296-how-we-build-safer-anesthesia-teams-one-trainee-at-a-time/ [https://www.apsf.org/podcast/296-how-we-build-safer-anesthesia-teams-one-trainee-at-a-time/] © 2026, The Anesthesia Patient Safety Foundation