VOLUME 30, ISSUE 2

I have a son, Zak, who is an internationally-known juggler. I taught my son to juggle three balls when he was 10 years old and he quickly used YouTube videos to teach himself additional skills. It was not very long before he surpassed me, as I have been stalled at 3-ball juggling for two decades. The art of juggling is full of complexities that I never fully understood prior to watching my son learn more complex juggling patterns. In fact, one study showed that expert jugglers develop a higher gray matter density in regions involved in visual motion perception and eye-hand coordination.1 Slight variances in techniques can lead to major changes in a juggler’s ability to successfully perform. As a life-long learner in anesthesiology, I recognize that there are many complexities in our environment that can put patients at risk if we are unaware or ill-prepared to manage slight variances. In our profession, we are often juggling many things trying to achieve the best patient outcomes and safely navigate our patients through the hazardous environments that are the operating rooms and procedural suites. Small variances can lead to drastic changes in a patient’s condition. As we try to keep all of the “balls in the air,” the target safety goals can be elusive as processes change, new medications emerge, and other patient factors come into play. It is important to remain vigilant and knowledgeable with regards to patient safety. With that goal in mind, this edition of the TSA Newsletter carries a patient safety theme.

I think you will be very interested to read the articles contained in this edition. Our authors examine multiple areas of patient safety including pediatric regional anesthesia, an interesting perspective on the opioid crisis, sedation for pediatric dentistry, the impact of drug shortages in obstetric anesthesia, recognizing and dealing with anaphylaxis in the OR, a look at how the electronic medical record can interface with software to improve data collection for complications and near-misses. Our TSA President provides a timely overview of the TSA’s response to a couple of key patient safety issues (pediatric sedation and the opioid crisis). Finally, a very interesting trio of articles on fire safety in the perioperative area. The fire safety authors critically examine all aspects of fire safety including airway fires, fire in the surgical field, and the logistical hazards of a structural fire near the perioperative area. These articles will hopefully lead you to be introspective of your own practice and to examine how these factors impact your own environments, including what changes could be made to minimize risks for patients.

In addition to our safety articles, we will continue our series entitled “On the Shoulders of Giants: Legends of Texas Anesthesiology.” In this issue, the stellar career of Dr. Arthur Keats is examined with a reprint of an excellent summary of his career by Dr. Stephen Slogoff. As Dr. Slogoff stated to me recently, it is regrettable that “today’s young anesthesiologists never got to know (Dr. Keats).” This edition also includes a nice article by Dr. Jeff Steiner related to personal finance. Dr. Steiner has noted that education on finances is lacking in the typical busy clinician’s life. His article is a nice introduction to some basic concepts that we should all learn more about.

British philosopher John Armstrong said “You don’t ask a juggler which ball is highest priority. Success is to do it all.” We are often asked to multi-task and juggle multiple things at once, all of which are important. As we all juggle our complex and busy clinical schedules, I hope that you will find time to insert this edition of the TSA Newsletter into your juggling pattern.

Reference:

1. Gerber P, Schlaffke L, Heba S, Greenlee MW, Schultz T, Schmidt-Wilcke T. Juggling revisited-a voxel-based morphometry study with expert jugglers. Neuroimage. 2014; 95:320-5.