#306 Venezuelan Ancestry Anesthesia Alert

#306 Venezuelan Ancestry Anesthesia Alert

Catastrophic neurologic injury after a routine anesthetic is the kind of signal that stops you in your tracks, and that’s exactly why we’re talking about new perioperative recommendations for patients with maternal Venezuelan ancestry. We’ve seen reports of otherwise healthy adults and children who deteriorated after general anesthesia, with sevoflurane appearing repeatedly in the documented events. That pattern has led the American Society of Anesthesiologists and the Society for Pediatric Anesthesia to issue updated guidance aimed at preventing harm while the science catches up.  We walk through what clinicians need to know about the suspected mitochondrial link and why maternal lineage matters for risk assessment. We also discuss why a negative family history does not reliably protect a patient and why laboratories must be explicitly alerted to the mutation of interest because it has been historically labeled a normal variant.  Then, we get practical: how to screen for maternal Venezuelan heritage with care and sensitivity, how to explain the question without implying anything about immigration status, and how to approach anesthetic planning when definitive genetic testing is unavailable. We cover current thinking on avoiding volatile anesthetics, when regional anesthesia may help, considerations around propofol infusions, processed EEG monitoring, and postoperative observation for return to neurocognitive baseline. If this is helpful, please subscribe, share the episode with your team, and leave a review so more clinicians can find these patient safety updates. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/306-venezuelan-ancestry-anesthesia-alert/ [https://www.apsf.org/podcast/306-venezuelan-ancestry-anesthesia-alert/] © 2026, The Anesthesia Patient Safety Foundation

#305 Lead Infinitely

The fastest way to weaken patient safety isn’t a missing checklist, it’s a team that stops trusting each other. We dig into “infinite anesthesia” and the next step, “leading infinitely,” a practical relational leadership approach designed to build psychological safety, empathy, humility, and civility in perioperative care. We share why anesthesia professionals are uniquely positioned to lead across the full health system: we work at the intersection of surgeons, proceduralists, nurses, and hospital leaders, and we see how small culture signals impact big operational and safety outcomes. You’ll hear how trust-based teamwork can improve clinician well-being, strengthen system resilience, and support measurable gains in patient outcomes and retention. We also break down the Lead Infinitely workshop series and what makes it different: teams learn together, practice concrete behaviors, and graduate with a strategic plan instead of a solo certificate. The conversation moves from training to scale, including why research, early wins, and credible champions matter if this work is going to spread beyond the OR and into onboarding, governance, and daily clinical practice. If you want your workplace to feel safer, calmer, and more effective, listen now, share with a colleague, and subscribe so you don’t miss what’s next. After you listen, leave a review and tell us what leadership behavior you want to see more of on your team. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/305-lead-infinitely/ [https://www.apsf.org/podcast/305-lead-infinitely/] © 2026, The Anesthesia Patient Safety Foundation

#304 Infinite Anesthesia Is Not Unlimited Propofol

Workforce shortages and rising demand are squeezing perioperative teams from every side and that pressure can turn colleagues into rivals. We push back on that mindset and explore a different way to think about the future: “infinite anesthesia,” a long-term approach to anesthesia patient care and anesthesia patient safety that prizes trust, teamwork, and a workplace where every clinician is valued.   We share highlights from the APSF Newsletter article “Leading Infinitely in Perioperative Care” and hear directly from author, Dr. Matt Sherrer, on why relational leadership has to extend beyond anesthesia, nursing, and the operating room. When surgeons, proceduralists, and hospital leaders join the same conversation, improvement scales faster and sticks longer. We also break down the “finite vs infinite game” idea and translate it into concrete behaviors: building trusting teams, learning from worthy rivals instead of fighting them, staying flexible with systems thinking and human factors, and having the courage to name tension while still celebrating progress.   Then we get tactical with “crossing the chasm,” a model from the technology adoption lifecycle that explains why great ideas stall without early adopters and strong relationships. If poor communication drives preventable harm, civility and clear dialogue are not soft skills, they are core safety tools. We close with a candid reflection from Dr. Richard Dutton on how scope battles and politics can impair access and quality when there is already more than enough work for everyone.   Subscribe for the next conversation, share this with a colleague, and leave a review so more perioperative teams can build safer systems together. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/304-infinite-anesthesia-is-not-unlimited-propofol/ [https://www.apsf.org/podcast/304-infinite-anesthesia-is-not-unlimited-propofol/] © 2026, The Anesthesia Patient Safety Foundation

#303 Measles in the OR

Measles can walk into your OR before the rash ever shows up, and that’s what makes perioperative measles planning so high stakes. We break down the timing that drives everything: incubation, the contagious window from four days before rash onset through four days after, and how recent exposure during an outbreak should change your elective surgery decisions. We also zoom out to the bigger picture behind today’s resurgence of measles, including declining vaccination rates and travel-related reintroduction. Then we get practical about what anesthesia professionals need at the bedside: how to confirm immunity status, what symptoms and complications to watch for, and why supportive care is still the core treatment strategy since there are no antivirals. We talk through high-risk groups, from infants to pregnant and immunocompromised patients, and why measles immune suppression can create downstream risk for secondary infection and delayed wound healing well after the acute illness. On the infection control side, we outline the precautions that protect your team and your facility: strict contact and airborne precautions and smart workflow choices like limiting staff to those with confirmed immunity status and using a negative pressure room for urgent or emergent procedures when possible. We also cover post-exposure prophylaxis options that can prevent or blunt infection, including vaccine timing and when immune globulin is indicated. For the full checklist mindset, we point you to the featured APSF article and the summary table that pulls the perioperative considerations together. Subscribe, share this with a colleague who takes call, and leave a review so more clinicians can find clear guidance on measles anesthesia safety and operating room infection control. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/303-measles-in-the-or/ [https://www.apsf.org/podcast/303-measles-in-the-or/] © 2026, The Anesthesia Patient Safety Foundation

#302 Reusable Versus Single-Use Airway Devices When Seconds Count

A difficult airway is hard enough in a modern hospital. Now imagine managing it on a ship, far from resupply, where “availability supersedes preference” and a device that worked last month might quietly drift out of spec. That’s the tension we unpack while exploring reusable versus single-use airway devices in humanitarian anesthesia and why planning is what protects patients when seconds count. We’re joined by Matt McGee, a Navy anesthesiologist who served as department head for anesthesiology aboard the USNS Comfort during Continuing Promise 2025. He walks us through what his team saw with reusable airway tools after repeated sterilization and handling, including progressive deformation of rigid stylets and how that kind of performance degradation can turn into delay during unanticipated difficult airway management. From there, we zoom out to the broader patient safety implications: infection control, sterilization capacity, operational throughput in multiple ORs, and the very real consequences of depending on a fragile supply chain for single-use equipment. We also take sustainability and ethics seriously. Single-use airway equipment can deliver consistency and simplicity, but it increases medical waste and can strain host-nation disposal systems, raising environmental stewardship questions that belong in the same conversation as laryngoscopes and video laryngoscopes. The takeaway is practical and actionable: build a hybrid airway equipment strategy, monitor reusable devices with systematic inspection protocols, plan redundant procurement buffers for disposables, and coordinate pre-deployment waste management with host partners. If you care about anesthesia patient safety in austere environments, global health, or perioperative systems planning, hit subscribe, share this with a colleague headed on mission work, and leave a review with your best tip for building redundancy without creating unnecessary waste. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/302-reusable-versus-single-use-airway-devices-when-seconds-count/ [https://www.apsf.org/podcast/302-reusable-versus-single-use-airway-devices-when-seconds-count/] © 2026, The Anesthesia Patient Safety Foundation