WLM:
Untapped Treasure
Of course we all know that our ASA headquarters is in
Park Ridge, Illinois, near Chicago. But how many of
us have visited our headquarters, home of the internationally
recognized Wood Library-Museum of Anesthesiology?
As the 2003 Wood Library-Museum Research Fellow, I recently
had the exhilarating experience of visiting our library
for an extended period of research. The anesthesiology
holdings are impressive, matched by few collections
in the world. The library presents the opportunity not
only to research a defined topic but also the exciting
prospect of browsing through very old books owned and
generously donated to the collection by the very pioneers
of our specialty, whose names are instantly recognized
by each of us.
Rare books from the 17th and 18th centuries provide
startling insights into how our predecessors viewed
disease and its treatment. Nineteenth century records
document the medical and cultural shockwaves that spread
rapidly through the civilized world after it became
apparent that anesthesia was “no humbug.”
Head Librarian Patrick Sim has provided great leadership
and stewardship in developing, cataloguing and preserving
the holdings throughout his career. He and his knowledgeable
and gracious staff are wonderful hosts, whether the
guest is a serious historical researcher or simply a
visitor wishing to browse and allow the complex and
textured history of our specialty to flow over him or
her.
The next time you visit Chicago, strongly consider a
visit to the Wood
Library-Museum!
Thomas J. Poulton, M.D.
Omaha, Nebraska
No-Fail
Solution to Propofol Problem
I was disappointed to read the item titled “Propofol
Use Restricted to Anesthesia Professionals”
in the April 2004 ASA NEWSLETTER. In my opinion,
ASA, the American Association for Accreditation of
Ambulatory Surgery Facilities and the Anesthesia Patient
Safety Foundation should be advocating the training
of all health care professionals who utilize procedural
sedation in the use of propofol. Intravenous sedation
with propofol clearly has a safer profile than the
use of intravenous midazolam, meperidine and morphine.
While our procedure room registered nurses are prohibited
from using it due to state nursing regulations (I’ve
been told), our emergency room physicians utilize
it on a daily basis. If it was not safer, why would
it be the procedural sedative of preference among
anesthesiologists and nurse anesthetists? This smells
of a “turf” issue, which should not be
a concern when “a better way” in relation
to patient safety exists.
I would be the first to agree that anesthesiology
professionals should be teaching proper use of procedural
sedation with propofol to nonanesthesia professionals.
Robert F. Goad, M.D.
Bainbridge Island, Washington
Editor’s Note: I personally
don’t see this as a turf issue. According to
the Joint Commission on Accreditation of Healthcare
Organizations, the head of the anesthesiology department
is responsible for all sedation and analgesia used
in the hospital. Airway management, the one thing
that anesthesiologists and nurse anesthetists do better
than any other health professionals, is the real issue.
With propofol the patient’s airway can quickly
become obstructed, something that nonanesthesia providers
often fail to recognize until profound desaturation
has occurred, if a pulse oximeter is in use. At least
intravenous midazolam, meperidine and morphine can
be “reversed.” Easier is not necessarily
better.
— D.R.B.
Propaganda
for AMA in April NEWSLETTER
It pained me greatly to see ASA, an organization I
respect, devote an entire
issue
of its NEWSLETTER (April 2004) to increasing
membership for the American Medical Association (AMA).
AMA does not represent the diversity found today in
medicine. It has always been behind the times, whether
it was accepting cigarette advertising or fighting
the creation of Medicare or jumping into the abortion
wars with an opinion on late-term abortion. (This
last was especially unnecessary and stupid.) I will
never join AMA, nor would any of my medical friends
— and I have lots. AMA will continue its downward
slide into terminal irrelevance. I do hope ASA is
clever enough to not link its future to AMA.
Tamar F. Singer, M.D.
Los Angeles, California
The views and opinions expressed in the “Letters
to the Editor” are those of the authors and do
not necessarily reflect the views of ASA or the NEWSLETTER
Editorial Board. Letters submitted for consideration
should not exceed 300 words in length. The Editor has
the authority to accept or reject any letter submitted
for publication. Personal correspondence to the Editor
by letter or e-mail must be clearly indicated as “Not
for Publication” by the sender. Letters must be
signed (although name may be withheld on request) and
are subject to editing and abridgment. |