Anesthesia Patient Safety Podcast

Hosted by Anesthesia Patient Safety Foundation

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Episodes

326

Latest episode

Sep 2026

Language

EN-US

About the show

The official podcast of the Anesthesia Patient Safety Foundation (APSF) is hosted by Alli Bechtel, MD, featuring the latest information and news in perioperative and anesthesia patient safety. The APSF podcast is intended for anesthesiologists, anesthetists, clinicians and other professionals with an interest in anesthesiology, and patient safety advocates around the world. The Anesthesia Patient Safety Podcast delivers the best of the APSF Newsletter and website directly to you, so you can listen on the go! This includes some of the most important COVID-19 information on airway management, ventilators, personal protective equipment (PPE), drug information, and elective surgery recommendations. Don't forget to check out APSF.org for the show notes that accompany each episode, and email us at podcast@APSF.org with your suggestions for future episodes. Visit us at APSF.org/podcast and at @APSForg on Twitter, Facebook, and Instagram.

Listen to episodes

60 recent

September 29, 2026Episode 32616 min

#326 Corneal Abrasions After Surgery

Eye pain in the PACU can trigger a reflex page to ophthalmology, but that reflex is not always the safest or most efficient choice. We provide considerations for perioperative corneal abrasions including why most are superficial epithelial injuries that heal quickly and how an anesthesia-led protocol can deliver fast relief without missing the rare dangerous presentation. If you’ve been unsure when a consult is truly necessary, this conversation gives you a practical, defensible path forward. We revisit a step-by-step PACU workflow: recognize symptoms early, perform a focused eye exam, assess for visual acuity changes, and use fluorescein staining with cobalt blue light to confirm a defect. We also share the ophthalmologist perspective on “uncomplicated” corneal abrasion management, including lubrication, antibiotic ointment options, and why routine consults can delay discharge, raise costs, and strain resources. The most important piece is the safety net: clear escalation triggers such as significantly reduced visual acuity, worsening or persistent pain, failure to heal, corneal infiltrate or ulceration, fixed pupil, hyphema or hypopyon, suspected foreign body or penetrating injury, stromal involvement, or dendritic staining. Then we pivot to medication safety and smart infusion pumps, spotlighting a real-world rollout of Baxter Novum syringe pumps in high-turnover procedural areas. We discuss how usability issues can suppress smart pump compliance, why human factors engineering matters, and how a team used AI to summarize narrative survey feedback into actionable themes. If you care about high-value perioperative care, patient safety protocols, and devices that actually work under pressure, this one is for you. Subscribe, share with your team, and leave a review with the one change you want to bring to your PACU or OR. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/326-corneal-abrasions-after-surgery/ © 2026, The Anesthesia Patient Safety Foundation

September 22, 20261 hr 33 min

#325 APSF Podcast Takeover: The HSSIB with CEO Dr. Rosie Benneyworth From The Medical Safety Podcast

A patient gets harmed, everyone wants answers, and the system too often responds with blame, silence, or a slow-moving inquiry that arrives years after the frontline has moved on. Today, we are hosting a special podcast takeover show from The Medical Safety Podcast. Hosted by Dr. Adam Shehata (former professional pilot turned physician) and Dr. Amir Hamid (anesthetist and emergency medicine physician), The Medical Safety Podcast focuses on how to improve our healthcare system by integrating human factors into systems safety, including medical incident investigation and proactive safety measures. This is Episode 10 where Adam and Amir discuss the Health Services Safety Investigations Body (HSSIB) - UK’s independent aviation-style investigatory body for medical incidents with their CEO, Dr. Rosie Benneyworth. We hope that you will subscribe to The Medical Safety Podcast for more conversations about healthcare systems improvement and patient safety. If you care about patient safety, medical incident investigation, healthcare systems improvement, and practical human factors insights, subscribe, share this episode with a colleague, and leave a review so more teams can build safer systems. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/325-apsf-podcast-takeover-the-hssib-with-ceo-dr-rosie-benneyworth/ © 2026, The Anesthesia Patient Safety Foundation

September 15, 2026Episode 32414 min

#324 Endotracheal Tubes Are Not All The Same

Your airway cart might look fully stocked, but one quiet change can reshape an entire intubation: a different endotracheal tube brand, a new material formulation, a redesigned cuff, or changes in diameter measurements. We take a close, practical look at endotracheal tube materials and design, and why supply chain instability and product discontinuations can turn a “routine” device into a patient safety risk, particularly for neonates, infants, and other pediatric patients where millimeters matter. We break down what actually varies between endotracheal tubes that share the same labeled size: PVC construction and the move away from DEHP, changes in flexibility, and how internal diameter, wall thickness, and manufacturing variability can increase resistance and impair ventilation. We also dig into cuffed endotracheal tubes and why there is no universal cuff standard. Cuff shape, cuff material, and contact surface area can change leak behavior, micro-aspiration risk, and the seal you rely on. Then we zoom in on failure points clinicians can miss, including pilot balloon and pilot line defects, the ability to pass a suction catheter in tiny cuffed tubes, distal tip designs that can deform, and when the presence or absence of a Murphy eye can matter in an emergency. To close, we read and reflect on a published statement responding to medication errors that harmed patients, reinforcing an essential distinction: a wrong drug or wrong route error is not the same thing as spinal anesthesia being unsafe. We highlight system safeguards that prevent neuraxial medication errors, including standardized labeling, separation of high-alert meds, and technology-assisted verification. Subscribe for more anesthesia patient safety deep dives, share this with a colleague who manages airways, and leave a review so more clinicians can find the show. What ET tube check has saved you from trouble? For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/324-endotracheal-tubes-are-not-all-the-same/ © 2026, The Anesthesia Patient Safety Foundation

September 8, 2026Episode 32320 min

#323 How Technology Can Speed Training And Strengthen Anesthesia Patient Safety

Your first day in anesthesia can be overwhelming with so many numbers, dials, alarms, and decisions that all land at once, and the stakes are high. We sit down with Dr. Lahiru Amaratanga to ask a simple question with big implications for anesthesia patient safety: how can technology make clinicians learn faster without losing the human touch that keeps patients safe? We dig into practical education innovation, starting with AI coaching and moving toward a “trainee dashboard” that could track real clinical experience like intubations, IV cannulation attempts, and areas that need deliberate practice. We talk about why this kind of visibility can help educators teach with confidence, reduce awkwardness for learners, and support competency-based medical education using spaced learning, mobile learning, and smart reminders. The goal is not more content, but better learning trajectories that translate into safer decisions in the OR. Then we widen the lens to teamwork and global safety. We reflect on what we can learn from high-performing day-to-day teams and surgeon anesthetist dyads, and why stable collaboration may improve outcomes. From an international anesthesia perspective, we highlight the need for minimal universal anesthesia monitoring standards and ask whether digital education closes the gap for low resource settings or risks widening it if new tools stay unaffordable. If you care about safer anesthesia care, smarter clinical training, and education that actually changes practice, listen now and share this with a colleague. Subscribe, leave a review, and tell us what innovation would most improve safety where you work. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/323-how-technology-can-speed-training-and-strengthen-anesthesia-patient-safety/ © 2026, The Anesthesia Patient Safety Foundation

September 1, 2026Episode 32229 min

#322 Designing Safer Anesthesia

The fastest way to improve anesthesia patient safety is often to stop asking people to be perfect and start redesigning the world they work in. Dr. Alli Bechtel sits down with Dr. Lahiru Amaratunge, a consultant anesthetist in Melbourne, to unpack how human factors engineering, smarter workflows, and better training systems can prevent harm before it happens. We trace Lahiru’s path from supervising medical students to building the ABCs of Anesthesia YouTube channel and the Anesthesia Collective, creating practical videos and resources that trainees can watch before they step into the operating room. He shares the real behind-the-scenes work: the fear of posting, the sting and value of criticism, and why a five-minute procedural video can take an entire day to produce. We also talk about scaling learning with recorded exam practice, plus new projects that leverage AI as an exam coach and interview coach. From there, we zoom into systems safety: designing out medication errors, reducing wrong-route neuraxial risk with NRFit connectors, and learning from morbidity and mortality cases where “simple” design flaws lead to devastating outcomes. Lahiru explains how closed-loop communication, flattening hierarchy, and in situ simulation in places like MRI and the cath lab build sharper teams. We end with an honest look at smartphones in medical education: incredible access, real distraction, and why checklists and handwritten recall still matter. Subscribe, share this with a colleague, and leave a review so more clinicians can find practical anesthesia safety ideas that work in the real world. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/322-designing-safer-anesthesia/ © 2026, The Anesthesia Patient Safety Foundation

August 25, 2026Episode 32127 min

#321 Safer Dental Anesthesia, PART 2

A dental office can feel low-stakes until the moment it isn’t. We pick up our conversation with Dr. Rita Agarwal to talk about the real-world safety gaps in dental sedation and dental anesthesia, especially for children, and the practical steps that can prevent a routine procedure from turning into a catastrophe. We walk through the exact questions families can ask before scheduling deep sedation or general anesthesia: What medications are being used? What level of sedation is planned, and how do you know it stays there? Who is responsible for the anesthesia, and is there a dedicated anesthesia provider whose only job is monitoring and rescue? Dr. Agarwal makes the key point behind the ASA sedation guidelines: sedation can go deeper than planned, so the team must be able to rescue from the next deeper level. That means airway rescue readiness, including the most basic lifesaving skill in the office-based anesthesia setting: effective bag-mask ventilation. We also talk about emergency medications and why asking about oxygen, naloxone, and flumazenil can reveal whether a practice is truly prepared. From there, we zoom out to the systems problem. We discuss why the U.S. still lacks consistent data and reporting, how state-by-state regulation creates uneven standards, and why simulation training should be routine anywhere sedation is delivered. Dr. Agarwal shares what she hopes to see next: better standardization, stronger requirements for deep sedation and general anesthesia, and robust databases that help us learn from every sedation, not just the cases that reach the news. If you care about pediatric dental sedation safety, office-based anesthesia, and preventing avoidable harm, listen, share this with a colleague, and subscribe. After you listen, leave us a review and tell us what change you want to see first in your state. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/321-safer-dental-anesthesia-part-2/ © 2026, The Anesthesia Patient Safety Foundation

August 18, 2026Episode 32038 min

#320 Dental Anesthesia Safety Gaps, PART 1

A dental chair shouldn’t be a place where safety standards slip, yet that’s the reality Dr. Rita Agarwal lays out with unsettling clarity. We talk through why office-based dental sedation and dental anesthesia can slide into dangerous territory: unclear definitions, uneven training, inconsistent monitoring requirements, and a system that often can’t even tell you how many serious complications occur. Dr. Agarwal, a pediatric anesthesiologist and longtime patient safety advocate, traces how dentistry and medicine evolved along parallel anesthesia paths, then explains what happens when those paths don’t share the same safeguards. We discuss the tragic story of six-year-old Caleb Sears and how “someone will be monitoring” can mean very different things across settings. From oral anxiolysis to deep sedation and general anesthesia with drugs like propofol and opioids, the episode highlights the moment risk spikes: when ventilation fails and no one in the room is trained, equipped, and empowered to rescue. We also get practical about what reduces harm right now: smarter patient selection (especially with comorbidities like obstructive sleep apnea or cardiac disease), consistent terminology that reflects the true depth of sedation, and an independent anesthesia professional whose only job is caring the patient. Finally, we dig into the dental anesthesia data problem and why reporting adverse events and near misses is the foundation for real systems change. If you care about patient safety, perioperative monitoring, and preventing clinical deterioration in any outpatient setting, listen through and share your take. Subscribe, share this episode with a colleague, and leave a review so more clinicians and families can find it. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/320-dental-anesthesia-safety-gaps-part-1/ © 2026, The Anesthesia Patient Safety Foundation

August 11, 2026Episode 31915 min

#319 Four New Studies That Change Daily Anesthesia Safety Decisions

Ketamine for emergency intubation has a reputation for hemodynamic stability, but does the best evidence back that up when your patient is truly sick? Today, we walk through four fresh research summaries that sharpen day-to-day anesthesia patient safety decisions, from airway management in shock and sepsis to the way teams and technology shape outcomes in the OR. First, we break down a large randomized controlled trial comparing ketamine versus etomidate for tracheal intubation in critically ill adults across U.S. emergency departments and ICUs. Mortality is similar, but ketamine shows more peri-intubation cardiovascular collapse, including hypotension and increased vasopressor use, especially in sicker patients. Our practical focus is how to choose an induction agent based on hemodynamic risk and how to prepare for peri-intubation instability. Next, we head into the cardiac OR to explore why surgeon-anesthesiologist dyad familiarity may be a systems-level patient safety strategy. A large retrospective study links more consistent pairings with lower operative mortality and better perioperative outcomes, raising real questions about scheduling, teamwork, and communication under pressure. We also review evidence on BIS-guided closed-loop anesthesia systems that improve anesthetic depth control by reducing excessively deep anesthesia without increasing light anesthesia, and we close with perioperative brain health, highlighting why routine preoperative cognitive screening is still uncommon and what resources could finally make it standard practice. Subscribe to the Anesthesia Patient Safety Podcast, share this with a colleague, and leave a review so more clinicians can find the latest evidence-focused perioperative safety insights. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/319-four-new-studies-that-change-daily-anesthesia-safety-decisions/ © 2026, The Anesthesia Patient Safety Foundation

August 4, 2026Episode 31816 min

#318 Air Embolism Alert

Air embolism is one of those complications that feels impossible right up until it happens fast, quietly, and with life-altering consequences. We walk through the FDA’s 2025 Early Alert on the Watchman access system for left atrial appendage occlusion (LAAO) procedures and connect the dots between device exchange steps, transseptal puncture, and the anesthetic choice that can put patients at risk. We talk about why the shift toward sedation and spontaneous ventilation in structural heart procedures can increase risk when an access system is open or imperfectly sealed. Negative intrathoracic pressure may create a suction gradient that favors air entry into the left atrium, where even small volumes can lead to coronary air embolism or cerebral air embolism. We also review what the FDA reported, including known cases of serious injury and death, and why registry rates may underestimate true events. From there, we translate guidance into practical anesthesia patient safety moves you can use in the interventional cardiology suite: when to consider controlled positive pressure ventilation and PEEP, what to watch during sheath manipulation, and how to set clear roles for sheath control, flushing, and line management. We cover prevention details like keeping components below the level of the heart, slow flushing to maintain a continuous fluid column, and performing exchanges under saline or water baths. We also outline an immediate response plan: recognize quickly, support hemodynamics, consider Trendelenburg positioning, aspirate air if indicated, and activate perfusion support early when available. If this topic touches your practice, share this with your cardiology and anesthesia team, then subscribe, leave a review, and send the episode to a colleague who does transseptal cases. What does your team do to prevent air entrainment during exchanges? For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/318-air-embolism-alert/ © 2026, The Anesthesia Patient Safety Foundation

July 28, 2026Episode 31730 min

#317 Setting Expectations For Safer Cesarean Anesthesia with Dr. Ruthi Landau Revisited, PART 2

Many patients walk into labor and delivery picturing a birth day, not an operating room, and that mismatch is where preventable suffering can start. We sit down with Dr. Ruthi Landau to get practical about cesarean delivery anesthesia, with a focus on patient safety, respectful communication, and what to do when a patient says, “This isn’t comfortable.” We dig into why setting expectations during neuraxial consent matters, and why active management of labor epidurals is not optional when an urgent intrapartum C-section may be around the corner. We also unpack what the literature keeps showing: epidural top-ups for intrapartum cesarean delivery are a common pathway to intraoperative discomfort. From re-dosing to adjuvants to real-time reassurance, we talk through concrete ways to prevent pain from being brushed off as “normal.” The conversation goes beyond the OR. A traumatic cesarean experience can shape the next pregnancy, fuel avoidance, and contribute to childbirth-related PTSD. We discuss trauma-informed care, offering debriefs, connecting patients to maternal mental health services, and using patient-reported experience measures to learn where systems fail. On the technical side, we cover pain management for general anesthesia cases, when to keep using an existing epidural, how neuraxial opioids fit with SOAP consensus monitoring guidance, and what a solid multimodal plan looks like when there is no neuraxial option including TAP or QL blocks, acetaminophen, NSAIDs, and opioid stewardship. Subscribe for more obstetric anesthesia and anesthesia patient safety conversations, share this with an anesthesia or OB colleague, and leave a review to help others find the show. What change are you most ready to make in your C-section anesthesia practice? For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/317-setting-expectations-for-safer-cesarean-anesthesia-with-dr-ruthi-landau-revisited-part-2/ © 2026, The Anesthesia Patient Safety Foundation