The podcast explores comprehensive recommendations for managing patients with non-cardiac implantable electrical devices during surgical procedures, emphasizing preoperative assessment, device interaction prevention, and safety protocols.

• Types of devices include vagal nerve stimulators, deep brain stimulators, and spinal cord stimulators
• Preoperative evaluation is crucial for identifying devices and contacting managing clinicians
• Algorithm provided for assessing potential interactions with electrocautery, MRI, and neuromonitoring
• Diathermy is absolutely contraindicated in patients with non-cardiac implantable devices
• Critical information needed includes device type, manufacturer, lead locations, and latest interrogation results
• Recent urgent safety alert issued about medication vial coring risks with specific interim recommendations

If you have any questions or comments, please email us at podcast@apsf.org. Visit apsf.org for detailed information and check out the show notes for links to all topics discussed.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/252-managing-neurologic-stimulators-a-critical-guide-for-safe-anesthesia/

© 2025, The Anesthesia Patient Safety Foundation

Surgical fires are devastating yet entirely preventable events that continue to occur in operating rooms around the world. This eye-opening episode features biomedical engineer Mark Bruley and anesthesiologist Dr. Jeffrey Feldman, who share decades of expertise investigating and preventing these catastrophic incidents.

The conversation reveals why the seemingly simple recommendation to limit open oxygen delivery to 30% is so critical for patient safety. Through forensic investigations and laboratory testing, we learn how oxygen-enriched environments transform common surgical materials into dangerously flammable substances. The experts describe the "two-fold risk" created when oxygen concentrations exceed safe limits: materials ignite more easily and flames spread exponentially faster, putting patients at serious risk of harm.

The experts outline clear, evidence-based approaches to prevent surgical fires, including the use of oxygen blenders for precise control and securing the airway when higher oxygen concentrations are clinically necessary. They share encouraging data showing significant reductions in surgical fire incidents over the past decade, while emphasizing that complete elimination is both possible and necessary.

Whether you're an anesthesia professional, surgeon, or perioperative nurse, this episode provides essential knowledge to protect your patients from this preventable complication. Visit the APSF website for comprehensive resources, including videos and algorithms, to implement surgical fire prevention protocols at your institution. By understanding and applying these recommendations, we can work together to ensure no patient is ever harmed by a surgical fire again.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/251-surgical-fires-the-30-oxygen-rule/

© 2025, The Anesthesia Patient Safety Foundation

Sugammadex safety considerations span across patient populations with renal impairment, pediatric patients, and pregnant or breastfeeding individuals, requiring nuanced clinical decision-making based on current evidence and ongoing research.

• Sugammadex reversal of moderate blockade is safe and faster than using neostigmine/cisatracurium for patients with renal impairment
• Quantitative neuromuscular monitoring is essential to ensure adequate reversal (TOF >90%)
• FDA approval exists for children 2+ years with the same dosing parameters as adults
• Infants <2 years require special consideration due to immature neuromuscular systems and distinct physiology
• Recurarization cases exist but are rare, primarily in very young patients
• Pregnancy considerations include theoretical concerns about progesterone binding
• Breastfeeding compatibility varies based on lactation stage, with early postpartum period requiring more caution
• Continued research needed to establish definitive guidelines, especially for neonates, infants, and lactating patients

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/250-sugammadex-in-special-populations-what-every-anesthesia-professional-needs-to-know/

© 2025, The Anesthesia Patient Safety Foundation