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Biomedical subjects

S M Ouellette

Publications and source records attributed to S M Ouellette.

8 recordsLinked to original sources
PubMed1998

AANA Journal course: update for nurse anesthetists--diabetes mellitus: overview and current concepts in anesthetic management.

Diabetes mellitus is one of the more common endocrine disorders encountered in the anesthetic management of surgical and obstetrical patients. These patients often have complications associated with the disease process which may increase perioperative morbidity and mortality. Optimal management depends upon an understanding of the disease process as well as special considerations unique to the diabetic. This AANA Journal course reviews the pathophysiology of diabetes and common complications associated with the disease. Perioperative considerations include assessment and metabolic control during the time of surgical stress. In concludes with acute complications and their recognition and management.

Anesthesia↗
PubMed1997

Financing nurse anesthesia education.

Health care spending in the United States outpaces all other nations or 14% of the gross domestic product. Although the escalating increases in health care costs which have characterized the industry over the past quarter century have begun to slow down, if changes in the current health care policy are not implemented, spending is expected to increase at a rate of 11.5% during each of the next 5 years. Health care spending will reach $1.1 trillion or 15% of the gross domestic product in the near future. Both hospitals and universities are facing mounting pressures to reduce their costs and improve their services. In this environment, it becomes increasingly important for directors of nurse anesthesia programs to financially justify their existence. This discussion begins with a brief overview of nurse anesthesia education in the United States. The value of and need for nurse anesthetists in the US health care system is addressed. Advantages and disadvantages of hospital versus university-based programs are highlighted and funding sources identified. Future needs and challenges in nurse anesthesia education conclude this discussion.

Cost-Benefit Analysis↗
PubMed1996

Clinical aspects of CRNA practice. General anesthesia.

General anesthesia is a state of reversible, descending depression of the central nervous system that is induced by inhalational or intravenous drugs. Components of general anesthesia include hypnosis, analgesia, amnesia, and muscle relaxation. Recognized anesthesia providers include CRNAs and anesthesiologists. Improvements in pharmacologic agents, technology, and education of providers have sharply reduced morbidity and mortality associated with anesthesia.

Anesthesia, General↗
PubMed1995

Regional anesthesia: is it safer?

This article provides an overview of the current status of general anesthesia and regional anesthesia techniques including complications occurring after using these techniques. The advantages, disadvantages, mortality, and morbidity are described for these two techniques.

Anesthesia, Conduction↗
PubMed1995

Mechanisms and management of allergic reactions in the surgical patient.

The use of anesthetic agents, drugs and chemicals during anesthesia induces a certain number of anaphylactoic or anaphylactoid reactions. The incidence of anaphylaxis during general anesthesia, according to a recent study, is 1:4500. Despite appropriate treatment, mortality is about 6%. Different mechanisms are involved in mortality. Multiple risk factors have been identified in at-risk patients. With adequate understanding of the pathophysiological events that occur during anaphylaxis, anesthetists may avoid the occurrence of allergic reaction or be better prepared to manage these serious situations that may become fatal. This article covers different areas associated with anaphylactic and anaphylactoid reactions. Focus is placed on the different mechanisms of allergic reaction, and special attention is given to the clinical aspects of this complication. Treatment of these reactions as well as steps in prevention perioperatively are highlighted.

Anaphylaxis↗
PubMed1983

A pharmacokinetic evaluation of the effect of plasma exchange on tobramycin disposition.

The effect of plasma exchange on the disposition of tobramycin was studied in three procedures done on two patients. Serum tobramycin levels were obtained when the subjects were off plasma exchange to calculate individualized tobramycin pharmacokinetic parameters. The amount of drug removed was measured and serum levels were obtained during plasma exchange. The effect of the procedure was evaluated by calculating the percentage of total body stores removed and comparing drug elimination half-life data on and off plasma exchange. The procedures resulted in the removal of 6.1%, 5.9% and 4.3% of total body stores of tobramycin. Plasma exchange provides an additional route of elimination for tobramycin which should be considered when dosing the drug in patients undergoing this procedure.

Adult↗
PubMed1982

Cost justifying a pharmacy residency program.

Cost justification of a pharmacy residency training program was prepared. The contributions of the pharmacy residents were tabulated and compared with the cost of the program to the hospital. Contributions were determined by identifying the activities performed by residents that could be quantified in financial terms. The residents' activities that benefited the hospital included administrative support, completion of special projects, scheduling staff assignments, and coordinating education programs. Costs were derived from salaries, fringe benefits, and training expense. An output value analysis was performed by comparing the contributions of the residents to the institution with the cost of the training program. The contributions of the residents exceeded the costs of the training program by a ratio of 1.3 to 1.

Budgets↗