Anesthesia Patient Safety Podcast

Anesthesia Patient Safety Foundation

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.

  1. 1D AGO

    #294 From Video Laryngoscopy To ECMO: What Keeps Airway Management Safe

    When air meets uncertainty, judgment matters most. We dig into the evolving landscape of airway management where video laryngoscopy, supraglottic devices, and even ECMO promise better outcomes, yet cognitive errors and non‑OR settings still account for many of the most devastating events. Drawing on recent studies, malpractice claims, and national audits, we map the pressure points that turn a difficult intubation into a crisis and show how to defuse them with clearer plans, tighter teamwork, and sharper skills. We start with three high‑yield rules that change outcomes fast: cap the number of attempts, anticipate physiologic crashes, and switch early to rescue strategies. From there, we unpack the INTUBE findings on hypoxemia and cardiovascular instability, plus data showing how repeated attempts compound failure. Video laryngoscopy gets a balanced look: why it lifts first‑pass success across ED and ICU intubations, and how overreliance can silently erode direct laryngoscopy and awake fiberoptic competence. Expect practical strategies to preserve breadth: intentional DL reps, awake FOI workshops, and shared mental models that define time limits and bailout triggers. We also tackle unsettled ground. Aspiration risk reduction remains murky; cricoid pressure under general anesthesia has not delivered clear benefits, and robust trials comparing asleep rapid‑sequence to awake, topicalized methods in high‑risk patients are missing. We offer a decision lens to tailor approach by anatomy, physiology, and available expertise. For extreme airways—think massive goiter or tracheal compression—we explore where ECMO fits: preemptive, standby, or rescue. You’ll hear how activation criteria, cannulation readiness, and interprofessional rehearsal turn a complex tool into a safety net rather than a new hazard. By the end, you’ll have a cleaner playbook: plan A–D that you can execute under stress, a review of device trade‑offs, and concrete ways to reduce cognitive traps that drive harm. If this conversation sharpens your next airway, share it with a colleague, subscribe for future episodes, and leave a quick review to help others find the show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/294-from-video-laryngoscopy-to-ecmo-what-keeps-airway-management-safe/ © 2026, The Anesthesia Patient Safety Foundation

    19 min
  2. FEB 10

    #293 Reimagining Anesthesia With AI, Wearables, And Safety Culture

    What if the anesthesia workstation could see trouble coming and stop it before it starts? We explore how anesthesia moves from reactive to predictive by blending AI, medical-grade wearables, and closed loop systems with a strong safety culture. The story of Alex—a 75-year-old who developed postoperative delirium and fell—anchors the stakes and shows how early signals, if recognized and acted on, can change a life. We break down practical uses of machine learning in the perioperative space: forecasting hypotension minutes ahead, integrating multimodal physiologic data for real-time decision support, and taming alarm fatigue with smarter, context-aware alerts. From operating room monitors to infusion pumps, interoperability turns scattered data into timely action.  Automation takes the next step with closed loop control. Imagine EEG-guided dosing that keeps hypnosis within target ranges, fluid and vasopressor titration that stabilizes hemodynamics, and a supervisory controller that coordinates these loops so clinicians can focus on communication, situational awareness, and patient advocacy. Through it all, safety culture remains the foundation: psychological safety, shared learning, and consistent prioritization of safety over short-term operational pressures. Technology should amplify the human connection, not replace it. You’ll leave with a clear view of what to pilot now—AI decision support in high-yield scenarios, targeted wearable programs for high-risk pathways, and structured training that embeds safety into daily practice. If this vision sparks ideas or questions, reach out and join the conversation. Subscribe, share with a colleague who cares about perioperative safety, 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/293-reimagining-anesthesia-with-ai-wearables-and-safety-culture/ © 2026, The Anesthesia Patient Safety Foundation

    16 min
  3. FEB 3

    #292 Forty Years Of Obstetric Anesthesia Progress And The Work Ahead

    Maternal safety has never mattered more, and the stakes span far beyond the delivery room. We revisit four decades of progress in obstetric anesthesia—from safer neuraxial techniques and airway strategies to medication safeguards—and then get honest about what still puts patients at risk. With author insights and frontline examples, we connect the dots between evidence, teamwork, and the lived experience of childbirth to show where anesthesia can lead meaningful change. Rising patient complexity reshapes our role. We lean into risk stratification with the Obstetric Comorbidity Index, proactive antenatal planning, and sustained postpartum follow-up. We address maternal mental health and substance use disorder with trauma-informed care and smarter pain plans. And we face inequity directly—why Black women bear disproportionate harm and how standardized pathways, equitable escalation, and advocacy move outcomes in the right direction. Looking ahead, we explore point-of-care ultrasound for neuraxial guidance and aspiration assessment, AI-driven tools for early detection, wearables for postpartum monitoring, and enhanced recovery after cesarean to cut variation and strengthen reliability. Subscribe, share with a colleague on labor and delivery, and leave a review with one change you’ll make this week to advance maternal safety. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/292-forty-years-of-obstetric-anesthesia-progress-and-the-work-ahead/ © 2026, The Anesthesia Patient Safety Foundation

    18 min
  4. JAN 27

    #291 Managing Anesthesia Risks for Patients with Acute and Chronic Cocaine Use

    A cocaine-positive patient rolls into the OR and the monitors look fine—until twenty minutes after induction, when the blood pressure plummets. We unpack that swing from sympathetic surge to sudden crash through two real cases: an emergent trauma laparotomy complicated by asystole and a chronic intranasal user with profound hypotension that only responded to direct-acting vasopressors. From there, we connect the dots to the pharmacology that makes these events predictable and, with the right plan, manageable. We talk candidly about what matters before wheels-in: timing of last use, objective signs of toxicity, and targeted testing. You’ll hear why urine screens can stay positive for weeks, why indirect agents like ephedrine can fail, and how phenylephrine or norepinephrine often become first-line choices. For regional anesthesia, we flag contamination risks and local anesthetic systemic toxicity concerns that call for dose adjustment and intralipid readiness. Chronic cocaine use adds another layer, including left ventricular dysfunction, myocardial infarction and fibrosis, and calcium dysregulation. Hospital policy and equity loom large. Automatic cancellations for cocaine positive patients can worsen pain, delay care, and disproportionately impact patients with limited access. We review current evidence suggesting many asymptomatic, cocaine-positive patients tolerate elective noncardiac surgery under general anesthesia with hemodynamics comparable to controls when vigilant management is in place. The takeaway: build flexible, evidence-informed pathways that prioritize patient safety without reflexive delays, and keep a rescue mindset with careful monitoring and direct vasopressors within reach. If this sparked ideas for your practice, subscribe, share with a colleague, and leave a review so more clinicians can find these insights. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/291-managing-anesthesia-risks-for-patients-with-acute-and-chronic-cocaine-use/ © 2026, The Anesthesia Patient Safety Foundation

    15 min
  5. JAN 20

    #290 From Blind Needles To Ultrasound: The Safety Revolution In Regional Anesthesia

    A remarkable safety story runs through regional anesthesia, from the era of blind needle placement to a modern practice guided by real-time ultrasound, lipid rescue, and reliable team checklists. We walk through the key milestones that cut complications, accelerated block onset, and lowered conversion to general anesthesia, while keeping a clear eye on the hazards that remain. Along the way, we explain how a simple seven-point timeout helps prevent wrong-sided blocks and why ultrasound has reshaped dosing, local anesthetic spread confirmation, and failure rates. We also dig into the numbers around local anesthetic systemic toxicity and neurologic injury, translating data into everyday decisions at the bedside. You’ll hear how improved dosing protocols, reduced volumes with ultrasound guidance, and rapid access to lipid therapy drive cardiac toxicity toward zero. We unpack the real contributors to failed blocks—anatomic variation, communication barriers, obesity, surgical factors, and experience—and share practical, high-yield steps for safer performance, from short-bevel needle selection to injection pressure monitoring and clear patient counseling. Looking forward, we explore the next wave of tools transforming the block room: 3D and 4D ultrasound for richer visualization, needle tip tracking for faster and steadier trajectories, and pressure monitoring that warns before harm. We spotlight how AI could assist with ultrasound interpretation, trajectory planning, and complication prediction, while wearables and high-fidelity simulation extend safety beyond the procedure to early detection and better training. If you care about preventing never events, reducing LAST, and building a resilient regional anesthesia workflow, this conversation lays out what works now and what’s coming next. Enjoyed the insights? Subscribe, share with a colleague, and leave a review to help more clinicians advance patient safety. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/290-from-blind-needles-to-ultrasound-the-safety-revolution-in-regional-anesthesia/ © 2026, The Anesthesia Patient Safety Foundation

    17 min
  6. JAN 13

    #289 Forty Years Of Anesthesia Medication Safety: What Works And What’s Next

    A single syringe swap should never decide a patient’s fate. We pull back the curtain on forty years of anesthesia medication safety to show what truly works—then tackle the hard part: getting proven safeguards into every OR, every time. From look-alike vial hazards to standardization that actually sticks, this conversation blends frontline realities with practical steps leaders can implement now. We dig into the high-stakes TXA wrong-drug, wrong-route crisis and explain why eliminating vials and moving to ready-to-administer IV bags is a must. Along the way, we unpack new FDA label warnings, the APSF–ISMP joint recommendations, and the forcing functions that prevent catastrophes, including NRFit for neuraxial routes and barcode verification at the point of care. We also surface quieter threats—vial coring, variable concentrations, and chaotic storages—and show how color-coded, readable labels and organized carts reduce cognitive load when seconds matter. Opioid safety gets equal focus. We connect preoperative risk assessment, multimodal analgesia, and smart postoperative monitoring to reduce opioid-related harm without compromising comfort. Technology has matured too: AI-driven clinical decision support can flag dosing and drug-choice risks in real time, but only if woven into workflows that clinicians trust. Throughout, we return to the implementation gap: success depends on leadership support, supply chain alignment, failure mode analysis, transparent reporting, and peer support that sustains a just culture. If you care about safer anesthesia—standardized labels and concentrations, prefilled syringes, organized storage, barcode checks, and a culture that learns—this is your playbook. Listen, share with your team, and help push your institution from knowing to doing. Subscribe, leave a review, and tell us which safeguard you’ll champion next. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/289-forty-years-of-anesthesia-medication-safety-what-works-and-whats-next/ © 2026, The Anesthesia Patient Safety Foundation

    20 min
  7. JAN 6

    #288 Forty Years Of Perioperative Medication Safety Progress

    Seconds define outcomes in the OR, and medication safety lives in those seconds. We take you inside four decades of work by the Anesthesia Patient Safety Foundation to show how our field shifted from relying on vigilance to building systems that make the right action the easy action. Along the way, guest contributor, Dr. Elizabeth Rebello, shares why standardization, technology, and culture are not buzzwords but lifelines when a single clinician must select, prepare, and administer drugs under pressure. We break down the STPC framework born from the 2010 Stoelting Conference—standardization, technology, pharmacy/pre-filled/pre-mixed, and culture—and translate it into real steps: standardized concentrations for high-alert medications, removal of concentrated lethal agents from the OR, barcode-based identification before draw-up or administration, and smart infusion pumps with user-friendly drug libraries. You’ll hear how prefilled syringes, automated dispensing, and clinical pharmacist integration reduce prep errors and free up attention when it matters most. The story moves forward with the 2018 focus on drug safety profiles and the stubborn challenge of shortages. We explore actionable ideas: building a standing shortage committee, communicating substitutions fast, simplifying carts and labels when suppliers change, and embracing multimodal analgesia.  By the end, you’ll have a clear map of what to implement now—printed labels, prefilled syringes, smart-pump integration with your anesthesia record—and what to champion next across your institution. Subscribe and share with a colleague who leads in the OR. Then tell us: which safety step will you push across the finish line this year? For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/288-forty-years-of-perioperative-medication-safety-progress/ © 2026, The Anesthesia Patient Safety Foundation

    19 min
  8. 12/30/2025

    #287 A New Era For PONV: Safety, Guidelines, And Smarter Rescue

    Nausea shouldn’t be the most memorable part of surgery. We take a clear, evidence-based look at postoperative nausea and vomiting, from identifying who’s at risk to building smarter prophylaxis bundles and choosing the right rescue when prevention falls short. With guest insights from Dr. Connie Chung, we unpack the Fourth Consensus Guidelines, translate them into practical workflows, and explore how Amisulpride—an atypical D2 antagonist—changes the game with an FDA indication for rescue after failed prophylaxis. We start by shrinking baseline risk: consider regional anesthesia when feasible, leverage TIVA with propofol, avoid nitrous and volatiles in longer cases, hydrate well, and spare opioids with multimodal analgesia. Then we scale prophylaxis to risk: dexamethasone at induction, 5-HT3 antagonists at the end, transdermal scopolamine for select patients, and low-dose Droperidol where appropriate. When prophylaxis fails, we explain why repeating ondansetron rarely helps and how switching classes boosts rescue success. Along the way, we map the safety terrain for D2 antagonists—QT prolongation, extrapyramidal risks, anticholinergic effects—so you can individualize care for elderly patients, those on antipsychotics, or anyone with potential drug interactions. We also dig into what’s new: contemporary analyses of Droperidol at antiemetic doses, and growing evidence that Amisulpride pairs well with Ondansetron or Dexamethasone to improve outcomes. Pediatric pearls include TIVA, fluids, and a two-drug prophylaxis backbone for longer or higher-risk cases. The result is a practical, stepwise approach you can apply tomorrow—reduce risk, layer mechanisms, and rescue smartly—to cut PACU delays, avoid unplanned admissions, and deliver a recovery that feels as good as the surgical fix. If this deep dive helps your practice, follow, share with your team, and leave a quick review to help others find the show. Tell us your go-to PONV bundle and whether your site stocks Amisulpride. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/287-a-new-era-for-ponv-safety-guidelines-and-smarter-rescue/ © 2025, The Anesthesia Patient Safety Foundation

    29 min
4.4
out of 5
26 Ratings

About

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.

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