#304 Infinite Anesthesia Is Not Unlimited Propofol

#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

#301 Pro-Social Operating Rooms

Work stress doesn’t come only from long days and hard cases in the operating room. It also comes from the invisible rules a team lives by: who gets heard, how conflicts get handled, what “efficiency” really means, and whether anyone feels safe enough to speak up. We take on operating room culture change through the lens of pro-social behavior and explain why small, voluntary actions like cooperation, gratitude, and direct support can translate into lower burnout, clearer communication, and stronger patient safety. We walk through Elinor Ostrom’s Nobel Prize winning core design principles for effective group collaboration and translate them into plain-language behaviors that OR team can actually use: shared purpose, fair decision-making, transparency, fast conflict resolution, and real accountability for helpful and unhelpful conduct. Then we pressure-test those principles against a clinical vignette where production pressure, hierarchy, and staffing strain pull clinicians away from the shared goal of safe, timely perioperative care and just having a nice day at work with colleagues. You’ll also hear from author Ramona Houmanfar on burnout measurement and psychological flexibility, plus insights from Mary Fearon on why interdisciplinary partnership matters for sustainable change. We close with Acceptance and Commitment Training (ACT) and the ACT matrix as a practical tool to notice counterproductive patterns, choose value-aligned actions, and build an OR environment where efficiency and well-being can finally support each other. Subscribe, share with a colleague who’s feeling the pressure, 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/301-pro-social-operating-rooms/ [https://www.apsf.org/podcast/301-pro-social-operating-rooms/] © 2026, The Anesthesia Patient Safety Foundation

#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