#309 Mold Risk In Anesthesia Workstations

#311 From Cable Chaos To One Step Airway Access

Twenty-two steps to reach an airway is not a quirky workflow problem, it’s a patient safety problem. We’re turning our attention to a neuro-interventional radiology (Neuro IR) suite where cables, monitors, and a poorly positioned anesthesia machine created a cramped, high-friction non-operating room anesthesia (NORA) environment. Joined by John Edwards, CRNA, we unpack how a real-world quality improvement project at the University of Kentucky Medical Center turned staff frustration into an evidence-based anesthesia workspace redesign. We start with what triggered the change: frontline clinicians describing barriers to optimal patient care, unsafe ergonomics, and a layout that made simple tasks unnecessarily hard. From there, we connect the dots to broader NORA safety expectations, including the American Society of Anesthesiologists guidance on having sufficient space, equipment access, and the ability to reach the patient quickly. Them, the team brings anesthesia staff, interventional radiology personnel, and facilities managers together to redesign the room with minimal disruption. You’ll hear the practical interventions that made the difference, like cable management using existing ceiling infrastructure, switching to a more compact anesthesia machine, and repositioning equipment to restore clear access to the patient. The results are striking: smoother movement, less clutter, improved morale, and a dramatic reduction in the distance to the airway. If you work in any NORA location, this is a blueprint for safer anesthesia workflows. Subscribe for more NORA safety and patient safety insights, share this with a colleague who works off-site, 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/311-from-cable-chaos-to-one-step-airway-access/ [https://www.apsf.org/podcast/311-from-cable-chaos-to-one-step-airway-access/] © 2026, The Anesthesia Patient Safety Foundation

#310 Moisture Matters In Anesthesia Circuits

Condensation in an anesthesia circuit looks harmless until it starts skewing flow sensor readings or creating the kind of warm, wet environment where microbes can thrive. We pick up the story after the investigation into moisture and mold concerns in GE operating room ventilators, then move straight into the questions clinicians asked most: which filters matter, how low-flow anesthesia changes the moisture equation, and what “moisture mitigation” actually means at the bedside. We walk through APSF guidance on filtration, including why a high-quality filter between the expiratory limb and the anesthesia machine is a key defense for keeping respiratory pathogens out of the workstation. We also talk about what HME filters do well for airway humidity and reducing moisture entering the machine, where their limits are (especially moisture generated by CO2 absorption), and why sidestream gas sampling lines deserve more attention in infection prevention and anesthesia machine protection. Then we share GE Healthcare’s response, including what’s universal across modern anesthesia breathing systems, what features support moisture management, and when optional condensers may help depending on clinical usage patterns. If this topic affects your OR workflow, subscribe, share the episode with a colleague, and leave a review so more anesthesia professionals can find these moisture management and patient safety insights. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/310-moisture-matters-in-anesthesia-circuits/ [https://www.apsf.org/podcast/310-moisture-matters-in-anesthesia-circuits/] © 2026, The Anesthesia Patient Safety Foundation

#309 Mold Risk In Anesthesia Workstations

Black particles in a breathing system are the kind of finding that makes every anesthesia professional stop and look twice. We’re sharing what a large health system uncovered after concerns for mold and moisture accumulation surfaced inside certain GE Healthcare anesthesia workstations used in operating rooms, especially during longer cases and in humid conditions. What started with a routine inspection quickly scaled into a broad audit of OR ventilators, a review of internal moisture points, and an urgent push for real-world mitigation. We walk through what the investigation found, what cultures grew, and the question everyone asks first: what is the risk to patients? We discuss why the available evidence suggests the infectious risk is likely minimal when high-quality heat and moisture exchange (HME) filtration and breathing circuit filters are used correctly, and why the team still pulled affected machines from service for sterilization per manufacturer instructions. Patient safety isn’t only about infection, though, and we also cover how excess condensate can affect flow sensors and tidal volume accuracy. Then we get concrete about prevention. We break down where moisture comes from inside an anesthesia ventilator, how low-flow anesthesia and rebreathing can increase water production in the circuit, and why simply turning up fresh gas flow isn’t the right fix when cost and environmental impact matter. You’ll hear the day-to-day moisture mitigation strategies that were implemented, including education, routine moisture and mold checks, overnight handling of circuits and sensors, and why add-on condenser drainage may be necessary for older compatible models. If you want a practical checklist mindset for anesthesia workstation maintenance, OR ventilator safety, and moisture management, this is for you. Subscribe, share with your colleagues, and leave a review so more teams can spot problems early and keep patients safe. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/309-mold-risk-in-anesthesia-workstations/ [https://www.apsf.org/podcast/309-mold-risk-in-anesthesia-workstations/] © 2026, The Anesthesia Patient Safety Foundation

#308 We Break Down The Latest Evidence On Safer Anesthesia Care

Delirium, pain, and prolonged ventilation can feel like “expected” bumps in perioperative care until you look closely at the data. We walk through four recent APSF In the Literature reviews and pull out what’s actually actionable for anesthesia patient safety right now, with clear numbers and real-world implications. First, we dig into a randomized controlled trial of S-ketamine for elderly patients undergoing total hip or total knee arthroplasty under neuraxial anesthesia. With general anesthesia out of the equation, the study reports a notable drop in postoperative delirium, raising practical questions about when S-ketamine belongs in your plan and how you weigh neuroprotection alongside analgesia. Next, we shift to the ICU after cardiac surgery and examine evidence on dexmedetomidine sedation and duration of invasive mechanical ventilation. We talk through the key nuance: dexmedetomidine is associated with longer ventilation overall, yet may shorten ventilation time in patients with a high “sedation burden,” highlighting how stacking sedatives can change the outcome you’re trying to optimize. We then move to labor and delivery with a large prospective cohort on pain during cesarean delivery with neuraxial anesthesia, including higher risk with urgent cases and epidural top-ups, plus an important signal on language and the need for interpreters. We close with a pediatric trial where EEG-guided sevoflurane titration reduces emergence delirium and speeds recovery in the PACU. Subscribe for weekly, evidence-focused anesthesia insights, share this with a colleague, and leave a review so more clinicians can find the latest perioperative patient safety updates. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/308-we-break-down-the-latest-evidence-on-safer-anesthesia-care/ [https://www.apsf.org/podcast/308-we-break-down-the-latest-evidence-on-safer-anesthesia-care/] © 2026, The Anesthesia Patient Safety Foundation

#307 Perioperative Safety In Low And Middle-Income Countries

The world has the knowledge to make anesthesia safer, but too often it’s the basics that are missing where the need is greatest. We’re talking about perioperative patient safety in low- and middle-income countries (LMICs), where a smaller share of surgical volume can still carry a massive share of perioperative death and disability. That imbalance isn’t inevitable, and it isn’t solved by one tool or one training course. It changes when systems change.  We walk through the biggest systemic barriers starting with anesthesia workforce shortages and the downstream effects on access, delays, and confidence in care. We also dig into national surgical, obstetric, and anesthesia plans (NSOAPs) and how partnerships with organizations like the World Health Organization and the World Federation of Societies of Anesthesiologists can help countries set targets, build capacity, and track progress.  From there, we get painfully practical: monitors, oxygen, essential medicines, and rescue drugs. We discuss the WHO Surgical Safety Checklist, what makes implementation succeed, and why the WFSA International Standards for a Safe Practice of Anesthesia matter as both a minimum safety floor and a roadmap for improvement. We close on a critical question for quality improvement everywhere: how do you build accountability when risk-adjusted outcomes data is hard to collect, and what solutions are most realistic?  Subscribe for more anesthesia patient safety conversations, share this episode with a colleague, and leave a review so more clinicians can find the show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/307-perioperative-safety-in-low-and-middle-income-countries/ [https://www.apsf.org/podcast/307-perioperative-safety-in-low-and-middle-income-countries/] © 2026, The Anesthesia Patient Safety Foundation