Anesthesia Patient Safety Podcast – Details, episodes & analysis

Anterior mediastinal masses make even seasoned anesthesiologists pause, and for good reason: a stable, upright patient can decompensate with a single change in position or a single dose of the wrong drug. We walk through a clear, stepwise approach that starts with anatomy and symptom red flags, then translates imaging, echocardiography, and pulmonary function testing into real-world decisions at the bedside. The focus stays practical: how to pick the safest setting, when to avoid general anesthesia, and what to prepare before anyone touches the airway.

We break down adult and pediatric risk criteria, including mass-to-chest ratio, degree of tracheal compression, SVC obstruction, pericardial effusion, and standardized tumor volume in children. From there, we outline sedation-first strategies using ketamine, dexmedetomidine, and carefully titrated remifentanil to preserve spontaneous ventilation and avoid precipitous loss of tone. For patients who truly need general anesthesia, we share an OR playbook: lower-extremity access when SVC flow is threatened, semi-upright preoxygenation, slow induction while maintaining spontaneous ventilation, awake intubation options, and selective use of short-acting agents to test tolerance of positive pressure.

Ventilation choices can make or break the case. We explain why long expiratory times and low respiratory rates reduce air trapping and auto-PEEP, and how fiberoptic bronchoscopy can guide tube position, predict extubation risk, and inform postoperative support. Rescue pathways are explicit: repositioning and CPAP, mechanical stenting with an endotracheal tube or rigid bronchoscope, rapid escalation to airway stents, and ECMO when distal collapse or cardiovascular compromise persists. We also spell out who needs ICU monitoring after surgery and why the safest path often means doing less.

If this topic raises your heart rate, you’re not alone. Tune in to sharpen your plan, align your team, and build a safer pathway from preop to postop for both adults and kids. Subscribe, share with your OR team, and leave a review with your best tip for managing high-risk mediastinal masses.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/283-how-to-plan-induce-and-recover-patients-with-anterior-mediastinal-mass-without-triggering-collapse/

© 2025, The Anesthesia Patient Safety Foundation

Ever walked into a new OR and spent the first ten minutes hunting for an airway bougie or a computer log-in that actually works? We dig into the hidden safety risks of a transient anesthesia workforce and share practical, fast-moving fixes that keep patients safe while keeping rooms open. With staffing shortages reshaping coverage models across the United States and beyond, locum clinicians are essential—but inconsistent environments, unclear escalation paths, and fragmented communication can turn small friction points into big hazards.

We unpack what the current evidence says—and doesn’t—about locum-related outcomes. A UK qualitative study surfaces predictable threats like unfamiliar systems and weak team integration, while primary care data shows prescribing differences without higher adverse events. In anesthesia, large safety studies are scarce, so leaders must rely on smart design: targeted orientation, standardized room setups, and shared mental models that don’t depend on who’s on the schedule. We also talk dollars and sense, highlighting a simulation-based break-even estimate for when full-time hiring outperforms locum coverage, and how to weigh cost without compromising safety.

From the main OR to higher-risk non-operating room anesthesia sites, we outline concrete steps that work across settings. Limit initial deployment to oriented locations, add locum staff to all communication channels from day one, and use checklists, cognitive aids, and universal timeouts to reduce variability. Establish clear role definitions and escalation trees posted in every anesthetizing location, and fold temporary clinicians into audits, feedback loops, and ongoing education. The aim is simple: compress the ramp-up, eliminate guesswork, and make the safe action the easy action—even when teams change daily.

If you care about perioperative safety, access, and team resilience, this conversation gives you a playbook to act now. Subscribe, share with a colleague who onboards locums, and email your best orientation tip so we can feature it on a future show.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/282-building-safer-anesthesia-teams-in-a-locum-driven-world/

© 2025, The Anesthesia Patient Safety Foundation

When our smallest patients need anesthesia care, their immature systems present unique challenges that demand specialized knowledge and vigilance. The risk of postoperative apnea in former preterm infants has long been recognized, but the evidence guiding management continues to evolve.

Join Dr. Alli Bechtel and pediatric anesthesiologist, Dr. Eva Lu-Boettcher as they explore the physiological vulnerabilities that make premature infants susceptible to respiratory complications after anesthesia. The conversation delves into the complex interplay between immature respiratory control centers and anesthetic agents, highlighting how premature infants respond differently to hypoxia and hypercapnia compared to their full-term counterparts.

Drawing from landmark studies and current literature, this episode offers clear, evidence-based recommendations for postoperative monitoring based on post-conceptual age and risk factors. You'll learn about the inverse relationship between post-conceptual age and apnea risk, the critical timing of apnea events, and practical guidelines for determining which patients require extended monitoring. The detailed discussion of monitoring protocols provides a roadmap for keeping vulnerable infants safe during the high-risk postoperative period.

What makes this episode particularly valuable is its practical approach to clinical decision-making. Whether you're determining if a 50-week post-conceptual age infant can be discharged after six hours of monitoring or establishing protocols for term infants who receive opioids, you'll find actionable guidance supported by the latest evidence. As Dr. Lu-Boettcher notes, ongoing meta-analyses and micro-analyses promise to further refine these recommendations in the near future, highlighting the dynamic nature of patient safety practices in pediatric anesthesia.

Curious about how your institution's protocols compare to current best practices? Wondering when it's truly safe to discharge a former preterm infant after anesthesia? Listen now to enhance your understanding of this critical aspect of pediatric anesthesia safety and help ensure that no child is harmed under your care.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/273-breathless-moments-when-premature-babies-need-extra-vigilance/

© 2025, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

Thanks for joining us in the New Year!! Tune in today for the exciting conclusion of our two-part Rapid Response series. We are reviewing the recommendations for pre-anesthesia machine checkout procedure and a couple cases of anesthesia machine malfunctions. If you are using older anesthesia machines, this episode may help identify a potential threat to anesthesia patient safety.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/183-rapid-response-anesthesia-machine-checkout-procedures-and-malfunctions-part-2/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

Tune in for a Rapid Response two-part series. First up, we discuss electronic interference between the radiofrequency detection wand, the Medtronic Situate Detection System X, and the Twitchview train of four monitorinng device from Blink Device Company. We also discuss the development of the pre-anesthesia machine checkout procedure before we review several cases of anesthesia machine malfunction next week.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/182-rapid-response-electronic-interference-and-anesthesia-machine-malfunction-part-1/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

We are back for Part 2 dedicated to discussing anesthetic considerations for patients undergoing endoscopic retrieval of food bolus or foreign body. Today, we are focused on choice of anesthetic technique, communication, and postoperative care. Spoiler alert: There is no uniform anesthetic approach.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/181-keeping-patients-with-food-bolus-impaction-or-foreign-object-ingestion-safe-part-2/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

What is your anesthetic plan for patients presenting for endoscopy to remove food bolus impaction or foreign body ingestion? Tune in today as we discuss important considerations when deciding on location for performing this urgent procedure, need for additional resources, and anesthetic plan including general anesthesia or monitored anesthesia care. This is Part 1 of a two-part series.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/180-anesthetic-considerations-for-patients-with-food-bolus-impaction/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

We have a Letter to the Editor show with exclusive content from the author that focuses on a preventable airway management disaster, unrecognized esophageal intubation. Tune in to learn about new guidelines to help prevent this event and help keep patients safe. Key points from the recommendations include using video laryngoscopy when possible and confirming sustained exhaled carbon dioxide and adequate oxygen saturation following successful tracheal intubation.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/179-a-preventable-airway-disaster/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

Anesthesia Professionals need to be aware of hazards in non-operating room locations while providing anesthesia care including patient transfers and invisible hazards. This is Part 2 of a two-part series all about clinician safety in NORA locations. Tune in to learn more about practical recommendations for making NORA locations safer with clinicians involved in room design, careful arrangement of anesthesia equipment, using a safety checklist, and mitigation of physical hazards.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/178-keeping-anesthesia-professionals-safe-in-nora-locations-part-2/

© 2023, The Anesthesia Patient Safety Foundation

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.

Anesthesia Professionals need to be aware of hazards in non-operating room locations while providing safe anesthesia care. This is Part 1 of a two-part series all about clinician safety in NORA locations. Tune in to learn about practical recommendations for room design that you can help implement at your institution.

Additional sound effects from: Zapsplat.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/177-anesthesia-professionals-beware-hazards-in-nora-locations-part-1/

© 2023, The Anesthesia Patient Safety Foundation