Anesthesia Patient Safety Podcast

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 alarming safety statistics—mortality rates potentially ten times higher than global averages for anesthesia-related deaths. This stark disparity highlights how regulatory gaps, substandard facilities, and inadequate patient selection can create perfect storms for adverse outcomes. The discussion illuminates how anesthesiologists can serve as safety champions by implementing rigorous standards and protocols. The conversation then pivots to a surprisingly common yet overlooked danger in pediatric anesthesia: the administration of oxymetazoline. What seems like a routine medication becomes hazardous when delivery systems designed for upright, conscious patients are used on supine, anesthetized children. Through practical demonstrations and creative problem-solving, we uncover how simple modifications to delivery methods—specifically using atomizers with precisely filled syringes—can prevent potentially dangerous overdoses and create standardized, position-independent dosing. Both topics underscore a central theme: anesthesia safety demands thoughtful adaptation of standards to fit unique circumstances. Whether dealing with international variations in practice or the specialized needs of pediatric patients, the commitment to "no one shall be harmed by anesthesia care" requires constant vigilance and innovation. We'd love to hear your experiences with similar challenges—have you encountered safety variations in different practice settings, or developed creative solutions to common problems? Visit APSF.org to explore our resources and join the conversation about advancing anesthesia patient safety worldwide. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/261-patient-safety-challenges-from-global-cosmetic-tourism-to-pediatric-medication-dosing/ [https://www.apsf.org/podcast/261-patient-safety-challenges-from-global-cosmetic-tourism-to-pediatric-medication-dosing/] © 2025, The Anesthesia Patient Safety Foundation

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 protocols that weren't part of traditional training. This educational void inspired her to create accessible, concise resources that meet modern learning preferences. Gone are the days of textbook deep-dives; today's professionals need searchable, digestible content they can absorb between cases or during brief study sessions. What makes these summaries particularly valuable is their breadth and collaborative development. Each summary is peer-reviewed and often created through mentoring relationships between experienced clinicians and trainees, creating educational value beyond the finished product.  Malinzak offers a clarifying perspective on how quality improvement relates to patient safety: "Patient safety is the goal... That's what we want to accomplish with every single patient. Quality improvement is the process... how we get to the goal." As anesthesiologists face increasingly complex cases and efficiency pressures, this distinction helps practitioners develop systematic approaches to protect vulnerable patients. Looking ahead, she envisions technologies like AI reducing administrative burdens so clinicians can focus entirely on vigilant patient care. Discover these valuable resources by visiting Open Anesthesia's website and filtering for patient safety topics – you never know which summary might teach you something new today. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/260-openanesthesia-and-the-apsf-achieving-safe-and-quality-anesthesia-care-with-education-innovation/ [https://www.apsf.org/podcast/260-openanesthesia-and-the-apsf-achieving-safe-and-quality-anesthesia-care-with-education-innovation/] © 2025, The Anesthesia Patient Safety Foundation

Intrahospital transport of critically ill patients presents significant safety risks that can be mitigated through proper guidelines, checklists, and handoffs between care teams. The episode examines transport-related adverse events and complications while providing practical tools to enhance patient safety during these vulnerable transitions. • Multiple categories of intrahospital transport adverse events including respiratory, cardiovascular, neurological and equipment-related complications • Risk factors for transport complications including patient characteristics, transport circumstances, and team experience • Society of Critical Care Medicine guidelines focusing on four components: communication, personnel, equipment and monitoring • Comprehensive perioperative transport checklist covering identification, airway, breathing, circulation, neurological status and equipment • Multi-Center Handoff Collaborative tools providing structured approaches to handoffs between care teams • Recommendations including pre-transport risk assessment, education for all team members, and implementation of standardized checklists • Importance of system design considerations like uncluttered hallways and team formations that optimize patient observation The deadline for the October 2025 APSF newsletter is July 1st. Check out the guide for authors at APSF.org for more information. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/259-every-move-matters-why-transport-safety-can-save-your-critical-patients/ [https://www.apsf.org/podcast/259-every-move-matters-why-transport-safety-can-save-your-critical-patients/] © 2025, The Anesthesia Patient Safety Foundation

The journey between hospital departments can be the most dangerous part of a patient's perioperative experience. This eye-opening episode dives deep into the hidden risks of intra-hospital patient transport. We examine the current literature on transport safety with particular focus on the challenges faced by anesthesia professionals. The data is sobering — between 4-9% of transported patients require medical intervention due to transport-related complications. With increasing production pressure, decreased support personnel, and rising patient acuity, we ask the critical question: are we transporting patients safely? We break down transport-related adverse events into essential categories: respiratory, cardiovascular, neurological, and equipment-related. The 2023 I-TOUCH study provides valuable insights, showing cardiac events, respiratory complications, neurologic issues, and equipment problems as the most common challenges during transport. We explore how patient factors (age, illness severity, ventilation requirements) and system factors (transport duration, communication gaps, staff experience) contribute to these risks. Beyond patient safety, we discuss the often-overlooked physical risks to anesthesia professionals themselves, who report high rates of work-related musculoskeletal injuries from maneuvering heavy transport equipment while managing patient care. The good news? Evidence-based guidelines exist to mitigate these risks. Join us next week as we continue this crucial conversation with practical recommendations from the American College of Critical Care Medicine and the Society of Critical Care Medicine for safer perioperative patient transport. Have you experienced challenges during patient transport? Share your experiences and learn from colleagues by emailing podcast@apsf.org or visiting apsf.org for more resources on perioperative safety. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/258-wheels-of-risk-when-patient-safety-rolls-through-hospital-corridors/ [https://www.apsf.org/podcast/258-wheels-of-risk-when-patient-safety-rolls-through-hospital-corridors/] © 2025, The Anesthesia Patient Safety Foundation

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have revolutionized treatment for type 2 diabetes, heart failure, and chronic kidney disease—but they're creating new challenges for anesthesia professionals. With more patients on these medications heading to surgery, understanding their unique perioperative risks has never been more critical. At the heart of this issue lies euglycemic ketoacidosis—a potentially life-threatening complication that's particularly insidious because it lacks the classic hyperglycemia that would normally trigger suspicion. We dive deep into the latest evidence, revealing that patients on SGLT2 inhibitors have an increased risk of developing postoperative ketoacidosis compared to those not taking these medications, with significantly worse outcomes when complications occur. We present a practical algorithm for risk stratification, considering factors like procedure duration, anesthesia type, diabetes control, and comorbidities. You'll learn which patients should hold their medication, which can proceed with caution, and what monitoring strategies to implement when patients haven't properly discontinued their medication before surgery. This guidance is especially valuable for emergency cases where postponement isn't an option. Whether you're developing institutional protocols or making decisions for individual patients, this episode equips you with the knowledge to navigate the complexities of SGLT2 inhibitor management in the perioperative period. Subscribe to stay informed about the latest in anesthesia patient safety and join our mission to ensure no one is harmed by anesthesia care. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/257-sweet-trouble-perioperative-management-of-sglt2-inhibitors/ [https://www.apsf.org/podcast/257-sweet-trouble-perioperative-management-of-sglt2-inhibitors/] © 2025, The Anesthesia Patient Safety Foundation