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Introducing OpenAnesthesia Summaries

Check out our new summaries which are mini-reviews
on high-yield topics in anesthesiology, critical care,
and perioperative medicine.

New Podcast Episode:
Global Health Equity
Ask the Expert

Dr. Elizabeth Drum and Open Anesthesia Editor Dr. Sam Percy discuss Dr. Drum's journey toward a career committed to global health and health equity and the work of the ASA Committee on Global Health.

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New Podcast Episode:
OA-SPA Ask the Expert

Dr. James Xie and OpenAnesthesia Editor Dr. Jina Sinskey discuss the Cures Act and transparency in medicine.

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Keyword of the Day

Awake acute blood loss acid-base

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Question of the Day

A 24-year-old man with a history of T4 paraplegia is undergoing his first anesthetic for a urinary diversion due to a neurogenic bladder. As the surgeon makes the incision, his BP reaches 220/110 mmHg with a heart rate of 45 bpm. Which of the following is the MOST appropriate first step in treatment?

Question of the Day

Explanation

In a patient with a history of a spinal cord lesion higher than T7, marked hypertension and bradycardia is concerning for autonomic hyperreflexia. Normally, descending inhibitory impulses travel down the spinal cord to block reflex arcs to cutaneous, visceral, or proprioceptive stimuli. This arc is disrupted in spinal cord injury and can lead to autonomic instability, most notably severe hypertension followed by a sustained vagal response including bradycardia, vasodilation, and cutaneous flushing. Treatment is supportive, including stopping the inciting stimulus (ask surgeons to pause) and lowering the blood pressure to normal levels via vasodilators and assuring adequate levels of anesthesia.

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Communication and Handoffs on Labor and Delivery: A Culture of Safety

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OA Global Health Equity Ask the Expert

Career in Global Health Equity

Samuel Percy, MD, Children's Hospital ColoradoMarch 2023

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OA-SPA Ask the Expert

Cures Act and Transparency in Medicine

Jina Sinskey, MD, FASA, University of California San FranciscoMarch 2023