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Anesthesia Patient Safety Podcast

Anesthesia Patient Safety Podcast

Hosted by Anesthesia Patient Safety Foundation

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Episodes

319

Latest episode

Aug 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
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

July 21, 2026Episode 31634 min

#316 Safer C-Section Pain Control Revisited, PART 1

If you’ve ever heard “it’s just pressure” during a C-section and felt your gut twist, you’re not alone, and it may be a patient safety issue hiding in plain sight. We sit down with Dr. Ruthi Landau, the Virginia Apgar Professor of Anesthesiology and Director of Obstetric Anesthesiology at Columbia University, to get practical about what patients actually feel during cesarean delivery anesthesia and what we can do when those sensations become uncomfortable.We talk through why labeling sensations as pressure versus pain misses the point, and why the better clinical question is simple: “Is it uncomfortable?” From there, we unpack a safer communication loop that invites patients to speak up and gives them real choices for relief, whether that means dosing through an epidural, using IV medication, or escalating plans when neuraxial techniques are not working. We also dig into opioid-sparing strategies for C-section pain management, including multimodal non-opioid analgesia, the risks of cookie-cutter discharge prescriptions, and how shared decision-making can reduce leftover opioids at home. Finally, Dr. Landau shares current practice insights on dexmedetomidine for shivering, anxiety, and visceral discomfort, along with the evolving evidence base and dosing approaches being used today.If you care about safer cesarean delivery, obstetric anesthesia best practices, and preventing opioid-related harm, subscribe, share this with a colleague, and leave a review so more clinicians can find the conversation.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/316-safer-c-section-pain-control-revisited-part-1/© 2026, The Anesthesia Patient Safety Foundation

July 14, 2026Episode 31516 min

#315 Pain During Cesarean Delivery

Pain during cesarean delivery is not “just pressure,” and it is not rare. We dig into why inadequate pain control during C-section remains underrecognized even as patient-reported data suggest it may be one of the most common anesthetic complications in obstetric anesthesia, with consequences that can reach far beyond the operating room including PTSD, postpartum depression, disrupted bonding, and lasting distress about birth.We walk through what the research has measured so far (conversion to general anesthesia, neuraxial replacement, and intravenous rescue medications) and what those markers can miss when the team does not recognize pain in real time. Patient stories, including lessons highlighted in The Retrievals podcast, make the safety gap impossible to ignore and help explain how bias, hierarchy, and cultural norms can quietly normalize suffering. We also unpack how language choices, especially the casual overuse of “pressure,” can minimize pain and derail clear assessment.From there, we get practical. We talk about shared decision making, objective ways to identify intraoperative pain, and how teams can escalate care: pause when possible, optimize neuraxial anesthesia, use evidence-based adjuncts, and move to general anesthesia when regional anesthesia is not sufficient. We also cover why systems matter, from reliable block testing to OR readiness for safe obstetric general anesthesia and postoperative follow-up when pain occurs.Subscribe for more anesthesia patient safety conversations, share this with a colleague on L&D, and leave a review so more clinicians can find it. What is one change you want your team to make after listening?For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/315-pain-during-cesarean-delivery/© 2026, The Anesthesia Patient Safety Foundation

July 7, 2026Episode 31414 min

#314 PACU Corneal Abrasion Protocol

Eye pain in the PACU can feel like an automatic page to ophthalmology, but it doesn’t have to be. We break down postoperative corneal abrasions on the show today. We share practical, clinician-ready guidance drawn from a multidisciplinary PACU corneal abrasion protocol developed with anesthesiology and ophthalmology expertise. You’ll hear exactly what to ask and look for when a patient reports blurry vision or a gritty sensation, the red flag that changes everything (vision loss), and how fluorescein stain plus a cobalt blue light exam can quickly sort a true corneal defect from keratoconjunctivitis or dry eyes. We also cover straightforward treatment for an uncomplicated corneal abrasion, including erythromycin ointment every four hours until symptoms resolve, along with clear follow-up rules when symptoms persist beyond 24 hours.Then, we dig into the quality improvement and operations side: how tracking cases in the electronic medical record supports reliable follow-up, how the protocol reduces unnecessary ophthalmology consults, and why this approach can improve patient satisfaction while protecting safety. You’ll also hear the real-world impact, including complete symptom resolution in tracked patients and substantial patient cost savings tied to avoided consult charges.Subscribe for more anesthesia patient safety insights, share this episode with a colleague who staffs PACU, 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/314-pacu-corneal-abrasion-protocol/© 2026, The Anesthesia Patient Safety Foundation

June 30, 2026Episode 31317 min

#313 Individualized Multimodal Analgesia

“Opioid-sparing” sounds like an automatic win until you look closely at what replaces the opioids. We take on one of the toughest questions in modern anesthesiology: how do we reduce opioid-related harm without trading it for medication interactions, kidney injury, bleeding risk, rebound pain, or poorly controlled postoperative pain?We break down what individualized multimodal analgesia really means in day-to-day anesthesia practice. That starts before the first dose is ordered, with a preoperative assessment that weighs comorbidities, baseline renal function, hydration status, and potential drug-drug interactions. We also dig into the medication safety side of multimodal protocols, including why CYP2D6 matters for common oral opioids like hydrocodone, oxycodone, and tramadol, and how CYP2D6 inhibitors such as certain antidepressants can change opioid effectiveness and even extend opioid use after discharge.Regional anesthesia remains a cornerstone, but we stay honest about the pitfalls: incomplete coverage, visceral pain that sneaks through, and the timing mismatch that can trigger rebound pain 12 to 24 hours after a single-shot block, sometimes when the patient is already home. We also discuss when continuous peripheral nerve blocks may better match the duration of perioperative stress and inflammation, plus the practical barriers that determine whether advanced regional techniques are feasible.If you care about opioid-sparing anesthesia, patient safety, and better postoperative recovery, listen and share this with a colleague. Subscribe to the podcast, leave a review, and tell us: what’s one change you’ll make to your multimodal analgesia plan after hearing this?For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/313-individualized-multimodal-analgesia/© 2026, The Anesthesia Patient Safety Foundation

June 23, 2026Episode 31215 min

#312 Hantavirus Readiness For Anesthesia Teams

A virus can feel “far away” right up until it lands in a preop bay with a fever, abdominal pain, and a story that only makes sense weeks later. We walk through what anesthesia, perioperative, and critical care teams need to know about hantavirus, why the incubation period (often 7 to 42 days) complicates detection, and how the Andes virus changes the conversation because it is the only hantavirus known to spread person to person.We start with the basics that matter at the bedside: common transmission pathways like inhalation of aerosolized particles from rodent droppings, the two major clinical syndromes (hantavirus cardiopulmonary syndrome and hemorrhagic fever with renal syndrome), and the pathophysiology that drives non cardiogenic pulmonary edema, shock, thrombocytopenia, and organ failure. We also cover diagnosis (PCR and antibody testing), reporting to public health, and why supportive care remains the foundation, including when ECMO may be considered as a bridge to recovery.Then, we bring it into the perioperative space with clear, practical infection control guidance for operating rooms and procedural areas. We talk elective case delays after known exposure, emergency surgery planning with bleeding risk, negative pressure isolation rooms, and PPE choices like N95 or PAPR for clinicians. We also share concrete anesthesia circuit precautions recommended by occupational health experts, including HEPA filtration placement, safer gas sampling scavenging, and how to handle circuit disconnections to reduce room contamination.If you want a focused, evidence aware checklist for hantavirus preparedness in anesthesia care, hit play, share this with a colleague, and subscribe so you do not miss the next safety update. After listening, leave a review and tell us: what is the single biggest gap in your OR infection control plan right now?For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/312-hantavirus-readiness-for-anesthesia-teams/© 2026, The Anesthesia Patient Safety Foundation

June 16, 2026Episode 31113 min

#311 From Cable Chaos To One Step Airway Access

Twenty-two steps to reach an airway is not a quirky workflow problem, it’s a patient safety problem. We’re turning our attention to a neuro-interventional radiology (Neuro IR) suite where cables, monitors, and a poorly positioned anesthesia machine created a cramped, high-friction non-operating room anesthesia (NORA) environment. Joined by John Edwards, CRNA, we unpack how a real-world quality improvement project at the University of Kentucky Medical Center turned staff frustration into an evidence-based anesthesia workspace redesign.We start with what triggered the change: frontline clinicians describing barriers to optimal patient care, unsafe ergonomics, and a layout that made simple tasks unnecessarily hard. From there, we connect the dots to broader NORA safety expectations, including the American Society of Anesthesiologists guidance on having sufficient space, equipment access, and the ability to reach the patient quickly. Them, the team brings anesthesia staff, interventional radiology personnel, and facilities managers together to redesign the room with minimal disruption.You’ll hear the practical interventions that made the difference, like cable management using existing ceiling infrastructure, switching to a more compact anesthesia machine, and repositioning equipment to restore clear access to the patient. The results are striking: smoother movement, less clutter, improved morale, and a dramatic reduction in the distance to the airway. If you work in any NORA location, this is a blueprint for safer anesthesia workflows.Subscribe for more NORA safety and patient safety insights, share this with a colleague who works off-site, 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/311-from-cable-chaos-to-one-step-airway-access/© 2026, The Anesthesia Patient Safety Foundation

June 9, 202613 min

#310 Moisture Matters In Anesthesia Circuits

Condensation in an anesthesia circuit looks harmless until it starts skewing flow sensor readings or creating the kind of warm, wet environment where microbes can thrive. We pick up the story after the investigation into moisture and mold concerns in GE operating room ventilators, then move straight into the questions clinicians asked most: which filters matter, how low-flow anesthesia changes the moisture equation, and what “moisture mitigation” actually means at the bedside.We walk through APSF guidance on filtration, including why a high-quality filter between the expiratory limb and the anesthesia machine is a key defense for keeping respiratory pathogens out of the workstation. We also talk about what HME filters do well for airway humidity and reducing moisture entering the machine, where their limits are (especially moisture generated by CO2 absorption), and why sidestream gas sampling lines deserve more attention in infection prevention and anesthesia machine protection.Then we share GE Healthcare’s response, including what’s universal across modern anesthesia breathing systems, what features support moisture management, and when optional condensers may help depending on clinical usage patterns.If this topic affects your OR workflow, subscribe, share the episode with a colleague, and leave a review so more anesthesia professionals can find these moisture management and patient safety insights.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/310-moisture-matters-in-anesthesia-circuits/© 2026, The Anesthesia Patient Safety Foundation

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