Episodios

  • #302 Reusable Versus Single-Use Airway Devices When Seconds Count
    Apr 14 2026

    A difficult airway is hard enough in a modern hospital. Now imagine managing it on a ship, far from resupply, where “availability supersedes preference” and a device that worked last month might quietly drift out of spec. That’s the tension we unpack while exploring reusable versus single-use airway devices in humanitarian anesthesia and why planning is what protects patients when seconds count.

    We’re joined by Matt McGee, a Navy anesthesiologist who served as department head for anesthesiology aboard the USNS Comfort during Continuing Promise 2025. He walks us through what his team saw with reusable airway tools after repeated sterilization and handling, including progressive deformation of rigid stylets and how that kind of performance degradation can turn into delay during unanticipated difficult airway management. From there, we zoom out to the broader patient safety implications: infection control, sterilization capacity, operational throughput in multiple ORs, and the very real consequences of depending on a fragile supply chain for single-use equipment.

    We also take sustainability and ethics seriously. Single-use airway equipment can deliver consistency and simplicity, but it increases medical waste and can strain host-nation disposal systems, raising environmental stewardship questions that belong in the same conversation as laryngoscopes and video laryngoscopes. The takeaway is practical and actionable: build a hybrid airway equipment strategy, monitor reusable devices with systematic inspection protocols, plan redundant procurement buffers for disposables, and coordinate pre-deployment waste management with host partners.

    If you care about anesthesia patient safety in austere environments, global health, or perioperative systems planning, hit subscribe, share this with a colleague headed on mission work, and leave a review with your best tip for building redundancy without creating unnecessary waste.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/302-reusable-versus-single-use-airway-devices-when-seconds-count/

    © 2026, The Anesthesia Patient Safety Foundation

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    17 m
  • #301 Pro-Social Operating Rooms
    Apr 7 2026

    Work stress doesn’t come only from long days and hard cases in the operating room. It also comes from the invisible rules a team lives by: who gets heard, how conflicts get handled, what “efficiency” really means, and whether anyone feels safe enough to speak up. We take on operating room culture change through the lens of pro-social behavior and explain why small, voluntary actions like cooperation, gratitude, and direct support can translate into lower burnout, clearer communication, and stronger patient safety.

    We walk through Elinor Ostrom’s Nobel Prize winning core design principles for effective group collaboration and translate them into plain-language behaviors that OR team can actually use: shared purpose, fair decision-making, transparency, fast conflict resolution, and real accountability for helpful and unhelpful conduct. Then we pressure-test those principles against a clinical vignette where production pressure, hierarchy, and staffing strain pull clinicians away from the shared goal of safe, timely perioperative care and just having a nice day at work with colleagues.

    You’ll also hear from author Ramona Houmanfar on burnout measurement and psychological flexibility, plus insights from Mary Fearon on why interdisciplinary partnership matters for sustainable change. We close with Acceptance and Commitment Training (ACT) and the ACT matrix as a practical tool to notice counterproductive patterns, choose value-aligned actions, and build an OR environment where efficiency and well-being can finally support each other.

    Subscribe, share with a colleague who’s feeling the pressure, and leave a review so more clinicians can find the show.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/301-pro-social-operating-rooms/

    © 2026, The Anesthesia Patient Safety Foundation

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    22 m
  • #300 Pro-Social Teams: Safer, Faster, Kinder
    Mar 31 2026

    The fastest way to make an operating room feel unsafe isn’t a broken monitor, it’s a team that stops acting like a team. We dig into pro-social behavior: the small, voluntary actions that support other people and the group, including kindness, cooperation, and gratitude, and why these behaviors can lower cognitive load, strengthen communication, and improve anesthesia patient safety when the schedule gets tight and the stakes are high.

    We share highlights from the February 2026 APSF Newsletter feature “Reduce Burnout, Improve Safety and Efficiency: Consider Pro-Social Behavior,” with insights from APSF leader Jeffrey Feldman. He connects persistent preventable harm and rising clinician burnout to the day-to-day culture in perioperative care, where interactions can become impersonal and inconsistent under production pressure. A vivid OR scenario brings it to life: a difficult airway, staffing constraints, unfamiliar teammates, and the clock driving tension instead of coordination.

    We also hear from Caoimhe Duffy, whose work in human factors and teamwork focuses on the “everyday actions” that keep patients safe before harm occurs. Her goal is practical: make positive behaviors more visible, more measurable, and easier to teach so teams can improve clinician well-being and patient safety at the same time. We close with a teaser for what’s next, including Elinor Ostrom's Nobel Prize-winning framework for collaboration and how it could offer an out-of-the-box model for building stronger perioperative teams.

    Subscribe so you don’t miss part two, share this with a colleague who’s feeling the pressure, 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/300-pro-social-teams-safer-faster-kinder/

    © 2026, The Anesthesia Patient Safety Foundation

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    16 m
  • #299 Cannabis And Anesthesia
    Mar 24 2026

    Cannabis has gone mainstream, but perioperative risk has not improved. THC products are far more potent than they were decades ago, emergency room visits are climbing, and many patients still walk into surgery thinking that it’s safe. We want anesthesia professionals to have a clearer, evidence-informed way to think about cannabis and anesthesia before the next case.

    We open the latest APSF newsletter feature article, “Cannabis and Anesthesia,” and bring in author Trisha Meyer to frame why this topic matters now. Together, we walk through the pharmacology that shows up at the bedside: THC vs CBD, CB1 and CB2 receptors, the endocannabinoid system, and how route of use changes onset and duration. Then we get practical about drug-drug interactions and highlight a free interaction-checking resource you can use in real time.

    From there, we map cannabis use across the perioperative timeline. Preop means asking better questions and documenting details like product type, dose, frequency, last use, and withdrawal symptoms, plus knowing when intoxication should delay elective surgery and when cardiac risk may need more workup. Intraop means expecting possible higher propofol and sedative requirements, watching for cardiovascular instability, and preparing for airway hyperreactivity and bronchospasm in inhaled users. Postop means planning for higher pain needs, using multimodal analgesia, and recognizing withdrawal, hypothermia, and shivering patterns that can surprise teams.

    If you care about perioperative patient safety, listen, share this with a colleague, and subscribe so you don’t miss what’s next.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/299-cannabis-and-anesthesia/

    © 2026, The Anesthesia Patient Safety Foundation

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    16 m
  • #298 New APSF Brain Health Guidance For Older Adults
    Mar 17 2026

    Postoperative delirium is one of the most common adverse events after surgery for older adults, and it can change a patient’s recovery, independence, and quality of life. We take a practical, evidence-focused look at what anesthesia teams can actually do to support perioperative brain health, using the latest recommendations from the APSF Brain Health Patient Safety Advisory Group.

    We walk through the four questions clinicians keep asking at the bedside. First, does intraoperative hypotension drive delirium? We break down why the data is mixed, what mechanisms make hypotension plausible, and why individualized hemodynamic goals with rapid correction still belong in a modern patient safety strategy. Next, we tackle benzodiazepines and the Beers Criteria: newer trials and practice advisories suggest short-acting agents like midazolam and ultra-short-acting options like remimazolam do not need to be avoided solely to prevent postoperative delirium, while medication review, deprescribing, and cognitive screening remain essential.

    From there, we get into anesthetic depth and intraoperative EEG monitoring. EEG guidance can reduce burst suppression and may help tailor dosing as part of precision anesthesia, but the evidence is still inconclusive on whether it prevents delirium in older adults. We close with the long-debated choice between general anesthesia and regional anesthesia, highlighting recent meta-analyses and trials showing no significant difference in delirium incidence once confounders are controlled, with a key nuance around avoiding excessive sedation.

    Subscribe for more anesthesia patient safety updates, share this with a colleague, and leave a review if the conversation helps you bring a brain health lens to your next case.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/298-new-apsf-brain-health-guidance-for-older-adults/

    © 2026, The Anesthesia Patient Safety Foundation

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    18 m
  • #297 From OR To ICU: How Checklists And Clean Hands Save Lives
    Mar 10 2026

    Transfers don’t have to feel like controlled chaos. We break down how to move a critically ill patient from the OR to the ICU with confidence by pairing structured handoffs with disciplined infection prevention—so information moves seamlessly while pathogens hit a dead end.

    We start by revisiting the ICU’s influence on anesthesia practice through the story of ARDS and lung-protective ventilation. The shift to 6 ml/kg ideal body weight didn’t just save lungs in the unit; it reshaped intraoperative strategy to reduce ventilator-induced injury for surgical patients. From there, we zoom into the human factors of handoffs: why complex, time-sensitive details—hemodynamics, antimicrobials, ventilator settings, imaging, and goals of care—so often fall through the cracks, and how IPASS, OR-to-ICU structured handoffs, and explicit role assignments align teams.

    Then we tackle pathogen transmission where it thrives: device-rich environments and high-touch surfaces. We unpack how environmental reservoirs and biofilms turn bed rails and anesthesia machine into unseen vectors, and why consistent, high-frequency hand hygiene is the most powerful countermeasure. Clear targets make habits stick: at least four sanitizer uses per hour in the ICU and eight per hour in the OR, coupled with strict isolation adherence and diligent decontamination.

    By the end, you’ll have a tight, transferable playbook: adopt lung-protective settings across care areas, script handoffs with shared tools and timed calls, measure sanitizer touches, and treat the environment as a clinical variable. If this conversation helps your team cut errors or infections, share it with a colleague, subscribe for future episodes, and leave a review with one change you’ll make this week.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/297-from-or-to-icu-how-checklists-and-clean-hands-save-lives/

    © 2026, The Anesthesia Patient Safety Foundation

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    15 m
  • #296 How We Build Safer Anesthesia Teams, One Trainee At A Time
    Mar 3 2026

    A small air bubble, a missed monitor cue, a late call for help—tiny moments that can change everything. We sit down with Dr. Max Feinstein to unpack how real-world anesthesia education builds safer clinicians, why attention is our most precious resource, and how culture—not heroics—prevents harm. From clear talk about morbidity and mortality to practical tactics like just-in-time simulation and curated literature, we map out a grounded approach to training that sticks under pressure.

    For new attendings, the leap to autonomy can feel surreal. We talk through imposter syndrome, the virtue of asking for help early, and how to choose a practice that backs safety over production pressure. Want red flags? Proceeding with non-NPO patients or brushing off new chest pain are hard stops. You’ll also hear about Dr. Feinstein’s current research in blood and transfusion management for cardiac surgery, his YouTube channel that demystifies anesthesia for learners and patients, and a nonprofit close to his heart, Heart Care International, supporting care for kids with congenital heart disease.

    If you care about anesthesia safety, team culture, and teaching that actually changes behavior, this conversation will give you tools you can use on your next case. Subscribe, share with a colleague who mentors trainees, and leave a review with your top strategy for reducing OR distractions—what works best for your team?

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/296-how-we-build-safer-anesthesia-teams-one-trainee-at-a-time/

    © 2026, The Anesthesia Patient Safety Foundation

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    19 m
  • #295 From OR To YouTube: What Happens When Patient Safety Meets Digital Storytelling
    Feb 24 2026

    Curiosity can change a career—and a field. We sit down with pediatric cardiac anesthesiologist and creator Dr. Max Feinstein to trace how a love of ethics, a pandemic schedule, and a phone camera evolved into a mission to make anesthesia safer through clear, accessible education. From the first CA1 walk throughs to high-stakes cardiac cases, Max explains how video demystifies monitors, medications, and moments that raise anxiety for patients and challenge new clinicians.

    We dig into the roots of patient safety—why medication errors still matter, how standardized setups and closed-loop communication reduce risk, and where pediatric data remains thin. Max shares the unexpected insights from filming veterinary anesthesia, revealing shared tools and parallel workflows across species. He also talks candidly about the hardest shoot: obtaining layered consent in the OR, balancing transparency with compassion, and earning trust from everyone in the room.

    Now serving as the inaugural APSF digital editor, Max walks us through building collaborative patient-safety videos on platforms people actually use. Think opioid safety explained for patients, monitoring made visual for trainees, and practical lessons from human factors that stick when the pressure is high. Along the way, we highlight how partnerships with experts, attorneys, and working groups help turn guidelines into engaging stories that change behavior, not just views.

    If you care about anesthesia patient safety, pediatric cardiac care, or how medical education is evolving on YouTube and beyond, this conversation offers tools you can use today. Subscribe, share with a colleague, and leave a review with the safety topic you want us to unpack next.

    For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/295-from-or-to-youtube-what-happens-when-patient-safety-meets-digital-storytelling/

    © 2026, The Anesthesia Patient Safety Foundation

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    21 m