Category Archives: Anesthesiology

Anesthesiology

An Interview with Dr. Anna Bowling Insights from a Dedicated Anesthesiologist and Coach – OCNJ Daily

Dr. Anna Bowling and her career in anesthesiology, marked by her dedication to patient care and her innovative approach to pain management, has also embraced a unique integration of coaching. Raised in North Carolina, Dr. Bowling moved to California in 2014 for her residency in anesthesiology at the University of California, Irvine, where she later completed a fellowship in acute pain management and regional anesthesia. Since 2018, she has been in private practice, working at several ambulatory surgery centers and incorporating her coaching skills to enhance her medical practice.

In this interview, Dr. Anna Bowling shares her journey, professional values, and insights into how coaching has influenced her approach to medicine.

I always looked forward to learning science and wanted to pursue a career in a STEM field. I wanted a life of purpose. Inherent interest, aptitude, and desire for contribution naturally led me to decide at a young age to pursue medicine.

When my best friends mom had emergent surgery for a ruptured intracranial aneurysm, I was amazed at what the doctors were able to do. They saved her life and gave the family their loved one back. Medicine became my calling. I wanted to help the sickest patients and be a pillar of strength on someones darkest days. This is what we do as anesthesiologists. We have the enriching and meaningful task of keeping patients safe through their surgeries and returning them to their loved ones.

I am passionate about making surgery as easy as possible for patients. I chose to do a fellowship in regional anesthesia because it helps achieve this aim. Regional anesthesia injects local anesthetic under ultrasound guidance precisely at the site where nerves or nerve bundles are located to achieve numbness of a specific body part, such as the shoulder, arm, or leg. I remember learning to do this procedure in residency and was amazed at how well it worked for shoulder surgery. My patients would awaken cognitively precise and pain-freelike nothing even happened except their arm is asleep. Of course, I must warn them that this medicine will eventually wear off, and they should be prepared. However, with the regional block, they wont sense any pain for 12-24 hours, which is when post-op pain tends to be the worst.

Regional anesthesia is also highly beneficial for elderly or otherwise high-risk patients. For example, if your grandmother falls and breaks her wrist, instead of putting her under general anesthesia, which carries more risk, we can numb her arm and give her sedation to sleep lightly. Im a huge advocate for regional anesthesia as a component of multi-modal, opioid-sparing anesthesia. Being a part of this pivot toward better patient care has reinforced my passion for medicine.

I value hard work, respect, honesty, and having a growth mindset.

Get a coach! My journey into life coaching has taught me more in a couple of years than Id absorbed in a lifetime. Examine your mind. It can be your best friend or your worst enemy.

Im proud of being humble, genuine, and caring. Im proud of staying true to myself no matter what. I have learned to draw strength from from any negative experience.

We focus on whats important and take care of that first. As anesthesiologists in a crisis, we focus on maintaining the patients vital organ functions and intervening where necessary. We can tune out everything that doesnt matter and communicate what is needed. Generally, I take the same approach in life, focusing my energy and time on whats most important.

Time and energy are the currency of your life. Reducing my life to what matters eliminates clutter, which manages stress and helps me feel that I am living my life purposefully. Remembering my purpose and reason for becoming a doctor keeps me balanced even when life gets unbalanced. Measuring our work-life balance like a pie chart is not realistic or helpful. At times, you will need to lean into your career, and at times, you will need to lean into your personal life.

Learning to shift your energy where its needed when its required ultimately leads to greater satisfaction in life. If you consciously maintain a sense of purpose in your work, no matter how difficult, it doesnt become something that must be counterbalanced. For me, the usual complaints of those in healthcare, such as dealing with challenging personalities, unrealistic expectations of others, unrealistic expectations, and high emotions, can all be softened through listening and understanding. Doing so has allowed me to function in a meaningful way that also helps those around me to keep feeling fulfilled and passionate about their work. Healthcare is a team sport; we must look out for each other. We all have the same goal. What we can deliver is fantastic when we work together, support each other, and lean on one another when we have to.

I define success as living a life that is fulfilling. When we spend our time doing something meaningful, we are more effective, learn more, and contribute more.

Whenever I need inspiration, I listen to David Goggins. David Goggins didnt let anything or anyone stop him from achieving his goals. He is the epitome of self-made.

Ive overcome most of the obstacles in my life on my own, but lately, Ive been learning from many great authors. After reading, The Body Keeps the Score, a book about post-traumatic stress disorder, I was awakened to how much possibility I was letting myself miss out on . It helped me understand my own experiences of trauma and break out of the darkness that it had brought. The silver lining of trauma is something called post-traumatic growth. Post-traumatic growth can be profound and more significant than it may otherwise have been. So, in essence, the most influential relationship in my life has been the one I have with myself. Through the words of authors like David Goggins, Bren Brown, Viktor Frankl, and Ryan Holiday, I have learned some of the greatest lessons in life.

Dr. Anna Bowling and her journey through medicine and coaching underscores the importance of dedication, continuous learning, and personal growth. Her insights into patient care, stress management, and work-life balance reflect a deeply thoughtful approach to her profession and personal life. Dr. Bowlings story is an inspiring example of how embracing challenges and seeking personal development can lead to a fulfilling and impactful career.

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An Interview with Dr. Anna Bowling Insights from a Dedicated Anesthesiologist and Coach - OCNJ Daily

Anesthesiology

Mitchell Named Fellow of American Association of Nurse Anesthesiology – The Elm – The Elm

Mitchell Named Fellow of American Association of Nurse Anesthesiology June 21, 2024 Mary Therese Phelan

As a newly selected fellow of the American Association of Nurse Anesthesiology, Jacqueline Mitchell is recognized as one of the most accomplished leaders in the nurse anesthesia profession.

Retired Col. Jacqueline C. Mitchell, MS 07, CRNA, FAANA, director of clinical education in the University of Maryland School of Nursing (UMSON) Doctor of Nursing Practice Nurse Anesthesia specialty, has been selected for induction as a 2024 fellow of the American Association of Nurse Anesthesiology (AANA). She will be inducted during AANAs Annual Congress in San Diego on Aug. 3.

As a fellow of the AANA, she is recognized as one of the most accomplished leaders in the nurse anesthesia profession. Earning the FAANA designation is a major career achievement that opens doors for certified registered nurse anesthetists as practitioners, educators, researchers, and advocates for the profession. The FAANA designation communicates a commitment to excellence, and acceptance criteria include contributions that have made a sustainable impact in the areas of clinical practice, education, research, and professional advocacy.

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Mitchell Named Fellow of American Association of Nurse Anesthesiology - The Elm - The Elm

Anesthesiology

Mitchell Named Fellow of American Association of Nurse Anesthesiology – University of Maryland School of Nursing

Baltimore, Md. Retired COL. Jacqueline C. Mitchell, MS 07, CRNA, FAANA, director of clinical education in the University of Maryland School of Nursing (UMSON) Doctor of Nursing Practice Nurse Anesthesia specialty, has been selected for induction as a 2024 Fellow of the American Association of Nurse Anesthesiology (AANA). She will be inducted during AANAs Annual Congress in San Diego on Aug. 3.

As a Fellow of the AANA, she is recognized as one of the most accomplished leaders in the nurse anesthesia profession. Earning the FAANA designation is a major career achievement that opens doors for certified registered nurse anesthetists as practitioners, educators, researchers, and advocates for the profession. The FAANA designation communicates a commitment to excellence, and acceptance criteria include contributions that have made a sustainable impact in the areas of clinical practice, education, research, and professional advocacy.

Being recognized is exciting and a humbling experience. It is a gift of inspiration to keep moving the profession forward, Mitchell said.

Mitchell joined the UMSON faculty as a clinical instructor in 2009. In her present role, she has oversight responsibility for 25 clinical rotation sites. Additionally, she lectures in several anesthesia practicum courses and works with students in simulation lab activities, workshop exercises, and competency sessions.

Mitchell retired as Colonel from the U.S. Army Nurse Corps in 2021. She served in the military for 30 years in a variety of clinical and command leadership assignments and deployments, including four years of active duty and 26 years of Reserve time.

Mitchell most recently served at the U.S. Army Medical Command in Texas as a nurse methods analyst, Drilling Individual Mobilization Augmentee. In this role, she was responsible for developing, analyzing, revising, and staffing organizational policies, standards, and practices related to health care delivery for medical specialties and nursing specialties across all Army components, including Reserve Component clinical issues.

Mitchell earned her Master of Science in Nurse Anesthesia and Certificate in Teaching in Nursing and Health Professions from UMSON, a Master of Science in Exercise Fitness and Health Promotion from George Mason University, and a Bachelor of Science in Nursing from the City College of New York. She is working toward a PhD in Nursing at UMSON, anticipating completion this December.

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The University of Maryland School of Nursing, founded in 1889, is one of the oldest and largest nursing schools in the nation and is ranked among the top nursing schools nationwide. Enrolling nearly 2,000 students in its baccalaureate, masters, and doctoral programs, the School develops leaders who shape the profession of nursing and impact the health care environment.

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Mitchell Named Fellow of American Association of Nurse Anesthesiology - University of Maryland School of Nursing

Anesthesiology

Medical Student Education | Anesthesiology & Critical Care Medicine | UNM School of Medicine | School of Medicine – The University of New Mexico

All third year UNM medical students complete a one-week rotation in anesthesia. This rotation is conducted through the Department of Anesthesiology and Critical Care.

As a medical student in this phasetworotation, you will learn basic concepts in applied pharmacology, pharmacokinetics, IV placement and airway management. These skills are crucial not only for those becoming anesthesiologists, but for physicians in other specialties such as family practice.

Build on your current medical and pharmacology knowledge.Examples of concepts you will learn include:

You will also participate in an interactive teaching sessionusingsimulated patientsto practice general anesthesia scenarios.

Several sessions of your rotation involve using passive mannequins to learn proper placement of IV lines and the essentials of advanced airway management. Master these skills on a mannequin and then spend two days in the operating room using these interventions on patients.

All students are expected to demonstrate insertion of a laryngeal mask airway, use an effective bag-mask ventilation on an anesthetized patient and start two IVs. You will be encouraged to perform endotracheal intubation, if possible.

Timewill be spent in the high-fidelity human simulator lab. Gain experience in applied pharmacology as well as additional experience in airway management in the context of patient scenarios.

At the end of rotation, the students will have experience in didacticsincluding practical experiencein IV and airway, hands on experience in the operating room and simulation environments. For more information, contact PramodPanikkath, MD,AssociateProfessor, atPPanikkath@salud.unm.edu.

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Medical Student Education | Anesthesiology & Critical Care Medicine | UNM School of Medicine | School of Medicine - The University of New Mexico

Anesthesiology

Department of Anesthesiology announces newly promoted faculty | Newsroom – University of Nebraska Medical Center

Several UNMC Department of Anesthesiology faculty members have a reason to celebrate following promotion announcements last month. Each is a distinguished professional in their field who is committed to upholding the mission clinical excellence, outstanding education and innovative research.

Promotion marks a major milestone in the academic lives of UNMC faculty, said Mohanad Shukry, MD, PhD, interim chair of the department. It demonstrates that they not only have met the high standards of their specialties but made significant contributions in their areas of responsibility and to the success of the department, as well.

Promoted to Professor

Promoted to Associate Professor

Promoted to Assistant Professor

We are truly fortunate to have such incredibly talented and dedicated faculty in the department, Dr. Shukry said. I invite the entire department of anesthesiology to join me in congratulating your colleagues.

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Department of Anesthesiology announces newly promoted faculty | Newsroom - University of Nebraska Medical Center

Anesthesiology

How we help 100000 surgical patients have positive experiences – Fraser Health Authority

Did you know that we perform more than 100,000 surgeries every year? This episode explores how we prepare patients for surgeries, how we support their recoveries, and everything that happens in between to help them have positive experiences.

Join host Dr. Victoria Lee for a fascinating conversation with Dr. Dave Konkin and Dr. Feisal Mohamedali, our regional medical directors and department heads for Surgery and Anesthesiology, respectively.

And be sure to subscribe to The Heart of It in your favourite podcast player app so you dont miss a beat.

Or listen to this episode in your favourite podcast player app.

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Dr. Dave Konkin is Fraser Healths regional medical director and department head for Surgery. His expertise lies in performing various major abdominal operations, including gastrointestinal, colorectal, gallbladder, trauma and hernia surgeries.

Dr. Feisal Mohamedali is Fraser Healths regional medical director and department head for Anesthesiology. His team specializes in caring for seriously injured patients resulting from car accidents, gunshots and stabbings.

Every episode, Dr. Victoria Lee, president and CEO of Fraser Health, take listeners to the heart of health care, where passion, dedication and innovation drive individual, community and planetary health.

Listen to and watch more episodes of The Heart of It here.

This episode of The Heart of It was recorded on the traditional, ancestral and unceded shared territories of the xmkym (Musqueam), Skwxw7mesh (Squamish) and slilwta (Tsleil-Waututh) Nations, and home to the Vancouver Sea to Sky Mtis Association.

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How we help 100000 surgical patients have positive experiences - Fraser Health Authority

Anesthesiology

Doctors perform kidney transplant on awake patient, who is out of hospital in 1 day – KERO 23 ABC News Bakersfield

Doctors at Northwestern Memorial Hospital in Chicago have performed a kidney transplant on a patient who was awake the whole time.

They say the technique used updated anesthesia methods which may now be used for more patients who would be considered too risky to go fully under, which is the standard now.

The patient, 28-year-old kidney disease patient John Nicholas, paves the way for more patients who are older and have more risks.

"There are a lot of people that have heart and lung disease that also need a kidney transplant, and that just increases the risk of general anesthesia even more," Dr. Satish Nadig, Comprehensive Transplant Center director and chief of abdominal transplant surgery at Northwestern Memorial Hospital in Chicago told Scripps News.

"There's a lot of people out there [and] they're very high risks for intubation, meaning getting a tube put into their throat to help them breathe. Very high risk for being on a ventilator. A lot of older people that need kidney transplants get cognitive or neurologic issues after general anesthesia," said Dr. Nadig.

Right now, kidney transplants are usually done with a patient fully unconscious under general anesthesia. In Nicholas' case, doctors used a spinal shot, also used in abdominal and pelvic surgeries like cesarean sections to deliver babies.

Relateds story: Researchers testing new bionic kidney for kidney disease patients

"Doing anesthesia for the awake kidney transplant was easier than many C-sections," Dr. Vicente Garcia Tomas, chief of regional anesthesiology and acute pain medicine at Northwestern Memorial Hospital said in a press release. "For John's case, we placed a spinal anesthesia shot in the operating room with a little bit of sedation for comfort. It was incredibly simple and uneventful, but allowed John to be awake for the procedure.

Being awake meant no invasive ventilator, and Nicholas used his own lungs. He could breathe, talk and interact with doctors. Other benefits include a shorter procedure and a faster and smoother recovery.

"He required zero opioid or narcotic pain medication. He was asking to eat, even during the surgery. That was a question he asked me while we were sewing the kidney in: 'When can I eat?'" Nadig said.

Nicholas went home after just one night in the hospital following his transplant, which is much shorter than the typical several days to a week post-kidney transplant.

That lowers the chance for complications. Research shows infection, bed sores, and bad drug reaction risk goes up the longer someone stays in the hospital.

Next, Nadig says they've identified five more patients for awake kidney transplants, opening the door to those considered too risky for general anesthesia.

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Doctors perform kidney transplant on awake patient, who is out of hospital in 1 day - KERO 23 ABC News Bakersfield

Anesthesiology

AI-driven alerts improve patient care escalation and survival rates in hospitals – News-Medical.Net

Deploying and evaluating a machine learning intervention to improveclinical care and patient outcomes is a key step in moving clinical deterioration models from byte to bedside, according to a June 13 editorial in Critical Care Medicine that comments on a Mount Sinai study published in the same issue. The main study found that hospitalized patients were 43 percent more likely to have their care escalated and significantly less likely to die if their care team received AI-generated alerts signaling adverse changes in their health.

We wanted to see if quick alerts made by AI and machine learning, trained on many different types of patient data, could help reduce both how often patients need intensive care and their chances of dying in the hospital. Traditionally, we have relied on older manual methods such as the Modified Early Warning Score (MEWS) to predict clinical deterioration. However, our study shows automated machine learning algorithm scores that trigger evaluation by the provider can outperform these earlier methods in accurately predicting this decline. Importantly, it allows for earlier intervention, which could save more lives."

Matthew A. Levin, MD, lead study author, Professor of Anesthesiology, Perioperative and Pain Medicine, and Genetics and Genomic Sciences, at Icahn Mount Sinai, and Director of Clinical Data Science at The Mount Sinai Hospital

The non-randomized, prospective study looked at 2,740 adult patients who were admitted to four medical-surgical units at The Mount Sinai Hospital in New York. The patients were split into two groups: one that received real-time alerts based on the predicted likelihood of deterioration, sent directly to their nurses and physicians or a "rapid response team" of intensive care physicians, and another group where alerts were created but not sent. In the units where the alerts were suppressed, patients who met standard deterioration criteria received urgent interventions from the rapid response team.

Additional findings in the intervention group demonstrated that patients:

"Our research shows that real-time alerts using machine learning can substantially improve patient outcomes," says senior study author David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, the Horace W. Goldsmith Professor of Anesthesiology, and Professor of Artificial Intelligence and Human Health at Icahn Mount Sinai. "These models are accurate and timely aids to clinical decision-making that help us bring the right team to the right patient at the right time. We think of these as 'augmented intelligence' tools that speed in-person clinical evaluations by our physicians and nurses and prompt the treatments that keep our patients safer. These are key steps toward the goal of becoming a learning health system."

The study was terminated early due to the COVID-19 pandemic. The algorithm has been deployed on all stepdown units within The Mount Sinai Hospital, using a simplified workflow. A stepdown unit is a specialized area in the hospital where patients who are stable but still require close monitoring and care are placed. It's a step between the intensive care unit (ICU) and a general hospital area, ensuring that patients receive the right level of attention as they recover.

A team of intensive care physicians visits the 15 patients with the highest prediction scores every day and makes treatment recommendations to the doctors and nurses caring for the patient. As the algorithm is continually retrained on larger numbers of patients over time, the assessments by the intensive care physicians serve as the gold standard of correctness, and the algorithm becomes more accurate through reinforcement learning.

In addition to this clinical deterioration algorithm, the researchers have developed and deployed 15 additional AI-based clinical decision support tools throughout the Mount Sinai Health System.

The Mount Sinai paper is titled "Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial." The remaining authors of the paper, all with Icahn Mount Sinai except where indicated, are Arash Kia, MD, MSc; Prem Timsina, PhD; Fu-yuan Cheng, MS; Kim-Anh-Nhi Nguyen, MS; Roopa Kohli-Seth, MD; Hung-Mo Lin, ScD (Yale University); Yuxia Ouyang, PhD; and Robert Freeman, RN, MSN, NE-BC.

Source:

Journal reference:

Levin, M. A., et al. (2024). Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial.Critical Care Medicine. doi.org/10.1097/CCM.0000000000006243.

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AI-driven alerts improve patient care escalation and survival rates in hospitals - News-Medical.Net