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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#287 A New Era For PONV: Safety, Guidelines, And Smarter Rescue (00:29:08)
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 afte...
#286 Pediatric Anesthesia Safety: Past Gains, Next Frontiers (00:21:02)
Safety for children under anesthesia shouldn’t depend on luck or location. We walk through 100+ years of progress in pediatric anesthesia and focus on the next wave of innovations that can make first attempts safer, dosing smarter, and systems more reliable—especially for neonates and infants who face the highest risk. We start with the historical milestones that changed outcomes: pulse oximetry, capnography, standardized monitoring, and the rise of pediatric training and ICUs. Then we exami...
#285 Safer Smiles (01:02:20)
A routine dental visit should never turn into a medical emergency. We sit down with Dr. Rita Agarwal, pediatric anesthesiologist and patient safety advocate, to unpack why dental anesthesia operates on a separate track from hospital-based care—and how that gap can put patients at risk. From the heartbreaking story of six-year-old Caleb Sears to the hard truths about monitoring requirements, staffing models, and training, this conversation brings clarity to a topic most families and many clini...
#284 Safer C-Section Pain Control with Ruth Landau, MD (01:02:44)
The fastest way to improve post-cesarean recovery is to start before the first incision—by setting expectations, testing the block, and validating what patients feel. We sit down with Dr. Ruth Landau, Virginia Apgar Professor and Chief of Obstetric Anesthesia at Columbia University, to map a safer path from the OR to the nursery: neuraxial-first analgesia, scheduled non-opioids, and small, truly PRN opioid prescriptions at discharge. She explains how intrapartum cesareans carry higher risk fo...
#283 How To Plan, Induce, And Recover Patients With Anterior Mediastinal Masses Without Triggering Collapse (00:28:38)
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 anes...
#282 Building Safer Anesthesia Teams In A Locum-Driven World (00:14:53)
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...
#281 Safer Anesthesia, Everywhere (00:28:12)
Imagine stepping into an operating room where oxygen isn’t guaranteed, capnography is rare, and one anesthesiologist might serve a million people. That’s the reality many patients face, and it’s exactly where meaningful change can save the most lives. We sit down with Dr. Kelly McQueen, professor of anesthesiology and department chair at the University of Wisconsin, to explore what it takes to deliver safe anesthesia in low and middle-income countries and how practical solutions—rooted in tra...
#280 Speak Up To Save Lives (00:23:51)
What if the biggest risks in maternal care are not just clinical, but cultural? We dig into the hard truth that speaking up can feel risky, pain during cesarean is often underestimated, and rare obstetric crises can overwhelm memory. From there, we chart a path toward safer births with practical tools that any team can use: psychological safety to unlock communication, structured pre‑briefs and rapid debriefs, and cognitive aids that turn chaos into coordinated action. We walk through the li...
#279 From Birthrooms To Boardrooms: Preventing Trauma And Elevating Maternal Anesthesia Care (00:21:43)
Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultura...
#278 Transforming Maternal Care Through Equity, Science, And Tech (00:16:21)
Maternal care is at a breaking point: delivering hospitals are disappearing while deaths that could be prevented keep climbing. We pull back the curtain on how structural racism, policy headwinds, and technology blind spots compound risk for birthing people—especially Black, Hispanic, rural, and low‑income patients—and what it takes to change the trajectory now. We start by naming the problem with data: stable birth rates alongside a steep decline in maternity units have created care deserts...
Welcome back to our 2025 Stoelting Conference Podcast Series. Fever isn’t the fail-safe it’s made out to be—especially in pregnancy. We walk through the subtle ways maternal sepsis hides in plain sight, why a quarter of those who died never had a fever, and how early warning tools, rapid antibiotics, and source control change the odds. From there, we pivot to maternal hemorrhage and show how quantifying blood loss with calibrated drapes plus a treatment bundle outperforms the old habit ...
#276 Maternal Care, Transformed (00:19:03)
Maternal safety changes when we stop relying on heroics and start building systems. We open the door to the 2025 APSF Stolting Conference series with a fast, practical tour of what truly reduces morbidity and mortality: collaboration across anesthesia, obstetrics, cardiology, and nursing; open‑source AIM bundles; early warning tools; and standards that compress time-to-treatment when minutes matter. Along the way, we confront the three deadly D’s—denial, delay, dismissal—and replace them with...
#275 Tracheostomy and Laryngectomy Patient Safety: Bedside Signs, Algorithms, and the Discipline that Prevents Catastrophe (00:16:49)
A patient rolls into the OR with a tracheostomy—do you maintain the current tube, intubate orally, or go through the stoma? We break down the decision tree that keeps patients safe, from assessing tract maturity and surgical needs to choosing cuffed vs uncuffed strategies and planning for positive pressure ventilation. Then we shift to a critical safety pivot: total laryngectomy. When the trachea is sutured to the skin, the mouth and nose no longer connect to the lungs, and attempts at oral i...
#274 Critical Decision Points in Emergency Tracheostomy Management (00:18:21)
Tracheostomy complications occur at an alarming rate, affecting nearly half of all patients during their initial hospitalization. When these emergencies strike, having a systematic approach can make the difference between life and death. We dive deep into the critical steps for managing a malfunctioning tracheostomy, beginning with immediate actions like cuff deflation and rapid information gathering about the tracheostomy's history. You'll learn how to systematically troubleshoot ventilatio...
#273 Breathless Moments: When Premature Babies Need Extra Vigilance (00:18:58)
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 anesthes...
#272 Behind the Waveform: Critical Safety Implications of CO2 Sensor Selection (00:16:20)
Could your CO2 sensor be putting patients at risk? This eye-opening Rapid Response to Questions from our Readers episode explores a serious patient safety concern that every anesthesia professional needs to understand. We dive into two troubling cases where patients under general anesthesia developed respiratory acidosis despite normal-appearing monitoring parameters. The culprit? A semi-quantitative CO2 sensor being used in an operating room setting where it was never designed to function s...
#271 Empowering Patients: The Key to Safer Anesthesia (00:15:32)
Patient engagement stands as the cornerstone of perioperative safety, bringing together the knowledge of medical professionals with the lived experiences of those receiving care. Through powerful personal testimonies and expert insights, we explore how this critical partnership transforms surgical outcomes. Vonda Vaden Bates shares her heartbreaking journey that began with her husband's successful brain surgery but ended tragically with a fatal pulmonary embolism. Despite their active engage...
#270 From Fears to Facts: Empowering Patients Before Surgery (00:16:05)
What happens when we truly listen to patients' fears about anesthesia? The Anesthesia Patient Safety Foundation (APSF) discovered something remarkable: despite the wealth of medical information available, patients' most pressing questions about anesthesia remained largely unanswered in accessible language. This episode delves into the groundbreaking work of the APSF Patient Engagement Workgroup, featuring insights from Maria Van Pelt. We explore how this initiative transformed patient concer...
#269 Infiltrated IV Crisis: Managing Complications and Keeping Patients Safe (00:14:28)
Every anesthesia professional has encountered IV infiltration—but when neuromuscular blocking agents are involved, this common complication becomes a complex patient safety challenge with no established guidelines. This episode delves into the critical management of infiltrated paralytics, a complication affecting 14% of peripheral IV catheterizations that can lead to delayed induction, compromised emergence, and potentially serious tissue injury. We're joined by Dr. Govind Rangrass, Profess...
#268 Beyond the Vein: The Dangers of Infiltrated Muscle Relaxants (00:15:34)
Ever wondered what happens when neuromuscular blocking agents infiltrate into surrounding tissue instead of flowing smoothly through an IV? The consequences can be serious and potentially life-threatening for patients recovering from anesthesia. We dive deep into a complication that affects nearly 14% of the 150 million peripheral IV catheter insertions performed annually in the United States. While most healthcare providers have experienced IV infiltrations, few understand the unique danger...
#267 Beyond Opioids: Revolutionizing Perioperative Pain Control (00:19:10)
Navigating the fine line between effective pain control and minimizing harm from opioid medications remains one of anesthesiology's greatest challenges. This episode dives deep into the evolving landscape of perioperative pain management, examining how clinicians can achieve the delicate balance required for optimal patient outcomes. Dr. Paul Guillod joins us to share his perspective as both an anesthesiologist and pain management specialist, highlighting how opioid-sparing techniques create...
#266 Protecting the Brain: Perioperative Stroke Prevention (00:21:02)
Perioperative stroke represents a rare but potentially devastating complication of anesthesia care. While occurring in less than 1% of non-cardiac surgical patients, this complication fundamentally threatens not just patient outcomes but their very identity. As Dr. Jacob Nadler poignantly notes in our podcast, "By maintaining brain health, we're preserving the essence of who our patients are—their memories, their personality, their ability to connect with friends and family." The most signif...
#265 The Breakthrough Drug Changing Perioperative Pain Management (00:15:22)
A revolution in pain management has arrived. The FDA's approval of Suzetrigine in January 2025 introduces the first non-opioid analgesic for moderate to severe pain in over twenty years. This breakthrough medication targets the voltage-gated sodium channel, NAV1.8, effectively blocking pain signals at their source before they reach the brain. What makes Suzetrigine remarkable is its precision. With over 30,000-fold selectivity for NAV1.8 channels, it delivers powerful analgesia without affec...
#264 Rethinking Resuscitation in the Operating Room: Beyond ACLS (00:15:40)
Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care. The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic...
#263 Blood Pressure Blind Spots (01:12:31)
The standard of care for monitoring blood pressure during surgery hasn't changed in nearly 40 years, despite technological advances that could prevent serious complications and save lives. This eye-opening episode takes listeners inside a recent Capitol Hill briefing where healthcare professionals, lawmakers, and patient safety advocates made the case for continuous blood pressure monitoring as a critical patient safety measure. Alarming statistics frame the urgency of this issue: one in nin...
