DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

More documents

Recommendations

Info

VETERANS AFFAIRS <strong>ANESTHESIOLOGY</strong> SERVICE Jonathan B. Mark, M.D. Chief, Anesthesiology Service Veterans Affairs Medical Center Associate Professor of Anesthesiology Associate Professor in Medicine Members: Jonathan B. Mark, M.D., Chief Thomas E. Buchheit, M.D. Joel S. Goldberg, M.D. Lewis R. Hodgins, M.D. David R. Lindsay, M.D. Laura E. Niklason, M.D., Ph.D. Thomas F. Slaughter, M.D. Gautam M. Sreeram, M.D. John (Sam) Thio Sum Ping, M.B., Ch.B., FRCA Dana N. Wiener, M.D Christopher C. Young, M.D., FCCM Pain Clinic: Joel S. Goldberg, M.D., Director Thomas E. Buchheit, M.D. David R. Lindsay, M.D. Surgical Intensive Care Unit: John (Sam) Thio Sum Ping, M.B., Ch.B., FRCA, Director Lewis R. Hodgins, M.D. Laura E. Niklason, M.D., Ph.D. Christopher C. Young, M.D., FCCM CRNA: Linda W. Skinner, CRNA, Chief CRNA Pauline F. Brault, CRNA, BSN Hazel Kerry, CRNA, MSN Li-Yuan M. Lo, CRNA, BSN James M. Neblett III, CRNA, MSN George W. Tennis, CRNA Robin W. Westbrook, CRNA, BSN Physician Assistant: Delmer L. Shelton, PA Valerie Forbes, PA, BS David W. Lewis, PA Research Assistant: Cynthia H. Cassell, BA, MA The Durham Veterans Affairs (VA) Medical Center is conveniently located across the street from Duke University Medical Center. Our VA anesthesia faculty provide comprehensive clinical anesthesiology services for the veteran population at this institution, including patients undergoing cardiac surgery, orthopedic joint replacement, major vascular, thoracic, neurosurgical, plastic, ENT, urologic, and ophthalmologic operations. Outside the operating rooms, our staff care for patients undergoing electroconvulsive therapy and those requiring painful diagnostic and therapeutic procedures in the cardiac catheterization laboratory, gastrointestinal, and radiology suites. Our service provides primary coverage for all patients in surgical intensive care, short stay unit, acute and chronic pain management services, diagnostic transesophageal echocardiography, and emergency airway management. The staff bring special expertise and interests to all of these clinical arenas. Faculty with subspecialty board certification work in intensive care and pain management, and contribute to accredited Duke departmental fellowship training programs in both of these areas. Other faculty members have advanced training and interests in cardiac anesthesia, regional anesthesia, geriatric anesthesia, fiberoptic techniques for airway management, and CLINICAL ACTIVITIES transesophageal echocardiography. The expansion and renovation of the VA operating rooms and recovery room continued during the past 12 months. In addition to a new heart room and major orthopedic room, both of which opened in late 1999, two more large operating rooms and a minor procedure room are complete and will be ready for clinical use after January 2001. At the same time, we will move into a new post anesthesia care unit (PACU), located adjacent to the new operating rooms. The new PACU will have updated monitoring capabilities, with the bedside displays supported from ceiling-mounted articulating booms. Other features include a new isolation room and extra bed spaces to accommodate preoperative patients, thereby allowing the PACU to serve both a pre- and postoperative function. The final phase of this extensive operating room project will begin this winter, when the entire original operating room suite will be closed for renovation. At the conclusion of this final phase, we will have three more renovated operating rooms, a new cystoscopy room, a new anesthesia workroom and anesthesia lab-office, and centrally located support and storage space for operating room and anesthesia functions. This project, once completed, should help the VA provide surgical services in a modern environment well into the next century. The VAMC Pain Clinic, directed by Dr. Joel Goldberg, is a busy multidisciplinary unit. In addition to sympathetic, neurolytic, and other major conduction blocks, diagnostic thermography is used regularly in the evaluation of clinic patients. The Pain Clinic serves as a training site for the departmental Fellowship in Pain Management. Residents and fellows in anesthesia and primary care rotate through the pain clinic as part of their training. Over the past year, our pain management physicians have accepted important new administrative roles. Dr. Goldberg was asked to participate on the American Board of Anes- CLINICAL ACTIVITIES 69
CLINICAL ACTIVITIES thesiology Pain Management Examination Committee, and Dr. Tom Buchheit was appointed as Co-Director of the Duke Anesthesia Division of Pain Management and as Pain Management Fellowship Director. Dr. Buchheit has also been very active clinically, both at Duke and at the VA and has expanded pain services by offering a variety of invasive techniques for patients who fail to respond to more conservative treatments. These procedures include radiofrequency nerve root ablation and implantation of spinal cord stimulators. Pain management services continue to grow at the VA, in concert with the VA national initiative to make pain the “5th vital sign.” During the past 12 months, the recruitment of two additional outstanding practitioners has helped our pain service continue to grow and serve as the leading VA pain referral center in the southeastern United States. Dr. David Lindsay, former chief resident and fellow in our department, returned to join the VA faculty December, 2000. His background in pain management and his interests in palliative care will lend additional experience and breadth to our pain service. We were fortunate as well in being able to recruit Marty Larson, Nurse Practitioner, to join the pain management team. Marty has already been active seeing patients in the clinic, assisting Dr. Buchheit in the operating room, and serving as co-chair of the hospital-wide pain initiative committee. In the latter role, she provides a unique opportunity for our service to have a close working relationship with hospital nursing staff, who carry out front-line management of pain in our veteran patients. The Surgical Intensive Care Unit (SICU) is an important responsibility of the Anesthesiology Service. Our faculty provide perioperative care for all surgical patients at the VAMC. Dr. John Sum Ping is the Medical Director of the unit, a new responsibility that he accepted this past year. Three other faculty share attending responsibilities: Drs. Lewis Hodgins, Laura Niklason, and 70 CLINICAL ACTIVITIES Christopher Young. Residents from the Duke Departments of Anesthesiology, Surgery, Family Medicine, and Obstetrics and Gynecology provide house staff coverage for this unit. This heterogeneous group of trainees provides a unique collaborative learning environment. As described below, the SICU also has been an active site for clinical research this past year, and a number of abstracts and manuscripts, focused on ICU sedation and hemodynamic monitoring have resulted from these efforts. Of note, Dr. Christopher Young was honored this year as a Fellow in the College of Critical Care Medicine and will be serving on the American Board of Anesthesiology Critical Care Examination Committee. Our 23-Hour Short Stay Unit (SSU) continues to grow and serve as the hub of perioperative patient preparation. It is conveniently located on the 4th floor adjacent to our operating rooms and new recovery room. Renovated just a year ago, the SSU provides additional space that allows more private examination rooms and improved patient waiting areas. Dr. Dana Wiener continues her effective leadership as the Medical Director of the SSU, and along with other staff anesthesiologists, she provides consultative medical direction to the three physician assistants who perform most of the patient evaluations on this unit. Mr. Bud Shelton, PA-C, has worked closely since 1995 to plan the SSU operations, guide its growth, and assure its success. Two other physician assistants, Ms. Susie Forbes, PA, and Mr. David Lewis, PA, complete the team on this unit. Each month, more than 300 patients receive care in the SSU, resulting in a marked reduction in average hospital length of stay for surgical and medical patients. Care maps for coronary artery bypass grafting and knee and hip joint replacement have originated in this unit and have been models for care throughout the VAMC. The unit has expanded to include medical patients who require a brief hospital stay for a variety of diagnostic or therapeutic procedures. In fact, nearly 25 percent of the patients seen in this unit are non-surgical patients, truly making this a multidisciplinary patient care service. The Transesophageal Echocardiography Service acquired new equipment this year for digital acquisition and storage of both intraoperative and other diagnostic echocardiograms. This is a very unique, state of the art imaging system, which allows rapid retrieval and review of any echocardiogram performed at the VA or at Duke. Its role in clinical care is already evident, and it will offer unique opportunities for clinical research in the future. The clinical success of the VA Anesthesia Service would be impossible without the ongoing contributions of an outstanding group of certified registered nurse anesthetists. Ms. Linda Skinner has provided superb leadership in her role as acting Chief CRNA and agreed to serve in this capacity on a more permanent basis this year. In 2000, we were fortunate to recruit two capable anesthetists, James Neblett and Robin Westbrook, to join our other experienced CRNAs, Pauline Brault, Hazel Kerry, Mary Lo, and George Tennis. Our CRNAs not only provide clinical care, but they also support the educational efforts of the faculty and serve the VA on a variety of committees. Members of the faculty also are active in hospital affairs and provide leadership in a variety of areas outside the operating rooms. Dr. Joel Goldberg chairs the Pharmacy and Therapeutics Committee, Dr. Thomas Slaughter chairs the Transfusion Committee, and Dr. Lewis Hodgins co-chairs the Ethics Committee. Research and Publication Year 2000 was a productive one for divisional research. Dr. Thomas Slaughter continues to work closely with Dr. Gautam Sreeram in the area of perioperative disorders of hemostasis. Both remain supported by NIH grants and commercial awards. Dr. Slaughter’s
Page 1 and 2:
DEPARTMENT OF ANESTHESIOLOGY Duke U
Page 3 and 4:
This issue is dedicated to the memo
Page 5 and 6:
DUKE DEPARTMENT OF ANESTHESIOLOGY M
Page 7 and 8:
FACULTY, RESIDENTS, FELLOWS, AND CR
Page 9 and 10:
FACULTY Thomas E. Buchheit, M.D. Cl
Page 11 and 12:
FACULTY Joel S. Goldberg, M.D. Assi
Page 13 and 14:
FACULTY John C. Keifer, M.D. Associ
Page 15 and 16:
FACULTY Joseph P. Mathew, M.D. Asso
Page 17 and 18:
FACULTY Claude A. Piantadosi, M.D.
Page 19 and 20:
FACULTY Mark Stafford-Smith, M.D.,
Page 21 and 22: FACULTY Christopher C. Young, M.D.,
Page 23 and 24: 20 FACULTY DUKE UNIVERSITY HEALTH S
Page 25 and 26: AFFILIATED FACULTY Scott T. Howell,
Page 27 and 28: Edmond C. Bloch, M.B., Ch.B. Associ
Page 29 and 30: INTERNS Atilio Barbeito, M.D. Abiga
Page 31 and 32: RESIDENTS John D. Mitchell, M.D. CA
Page 33 and 34: RESIDENTS CA-3 Tarsha V. Garvin, M.
Page 35 and 36: Paula D. Alford, B.A., CRNA Beatric
Page 37 and 38: CRNA Deborah J. Ferrero-Conover, CR
Page 39 and 40: CRNA Carolyn C. Knoop, CRNA, MSN Da
Page 41 and 42: CRNA Kena B. Sigman, CRNA, MSN Tede
Page 43 and 44: 40 DUKE ANESTHESIA FACULTY WHO BECA
Page 45 and 46: CLINICAL ACTIVITIES Infraclavicular
Page 47 and 48: CLINICAL ACTIVITIES CARDIOTHORACIC
Page 49 and 50: CLINICAL ACTIVITIES Goals for 2000
Page 51 and 52: CLINICAL ACTIVITIES Narda D. Crough
Page 53 and 54: CLINICAL ACTIVITIES returned home t
Page 55 and 56: CLINICAL ACTIVITIES GENERAL, VASCUL
Page 57 and 58: CLINICAL ACTIVITIES some of the ser
Page 59 and 60: CLINICAL ACTIVITIES years, has comb
Page 61 and 62: CLINICAL ACTIVITIES Molecular Biolo
Page 63 and 64: CLINICAL ACTIVITIES ORTHOPAEDICS, P
Page 65 and 66: CLINICAL ACTIVITIES OTOLARYNGOLOGY,
Page 67 and 68: CLINICAL ACTIVITIES PAIN MANAGEMENT
Page 69 and 70: CLINICAL ACTIVITIES therapy. This y
Page 71: CLINICAL ACTIVITIES Regional Anesth
Page 75 and 76: CLINICAL ACTIVITIES WOMEN’S ANEST
Page 77 and 78: BIOSTATISTICS AND CLINICAL OUTCOME
Page 79 and 80: DIVERS ALERT NETWORK extended to Co
Page 81 and 82: DEPARTMENTAL COMMITTEES David B. Sc
Page 83: 80 Thirteenth Annual ASA Duke Anest
Page 86 and 87: Several advances in the residency c
Page 88 and 89: The Annual Resident Graduation and
Page 90 and 91: Lectures, Conferences and Didactics
Page 104 and 105: 2000 BUSINESS OFFICE ANNUAL REPORT
Page 106 and 107: Anesthesia Technician Staff Sitting
Page 108 and 109: Hyperbaric Center Left to right Eri
Page 110 and 111: Molecular Pharmacology Laboratory F
Page 112 and 113: Signal Transduction Laboratory Fron
Page 114 and 115: The determination of the MAC reduct
Page 116 and 117: Magnesium neuroprotection in cardia
Page 118 and 119: Active Institutional Animal Care an
Page 120 and 121: Mackensen, George B., M.D. Peri-Isc
Page 122 and 123:
A Randomized, Double-Blind, Paralle
Page 124 and 125:
Cardiac surgery in infants and chil
Page 126 and 127:
An exciting development is the esta
Page 128 and 129:
services to pharmaceutical companie
Page 130 and 131:
Gerontological Research in Anesthes
Page 132 and 133:
Masaya Kudo, M.D. Daniel Morris, Ph
Page 134 and 135:
RESEARCH ASSISTANT Amy L. Kondyra V
Page 136 and 137:
Gan TJ, Apfelbaum J, Chen C. Instit
Page 138 and 139:
Pineda JA, Lynch JR, Laskowitz DT,
Page 140 and 141:
East CJ, Clements F, Mathew J, Slau
Page 142 and 143:
Mackensen GB, Stanley TO, Grocott H
Page 144 and 145:
Taekman JM, Web alert. Current Anes
Page 146 and 147:
Robertson KM. Donor management. Pro
Page 148 and 149:
145
Page 150 and 151:
Rosemary W. Cumbie Special Assistan
show all

DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

Create successful ePaper yourself

Delete template?

Save as template?