Anesthesia Patient Safety Podcast

Trust is getting harder to earn in healthcare, yet it might be the most important thing. We continue our coverage of the 2026 APSF Stoelting Conference series starting with Thomas Lee, MD, asking the uncomfortable question most systems avoid: what are we producing with all this work in healthcare? His answer lands with force. The product is trust, built through patient experience, reliable teamwork, and the everyday choices that tell patients we are coordinated, prepared, and on their side.

We dig into what actually earns patient trust, including why patients respond when they can see teamwork in action...

If your preop clinic feels overloaded, the answer might not be “work harder” it might be “triage smarter.” We share highlights from the 2026 APSF Stoelting Conference on how perioperative teams can match resources to risk, protect access for complex patients, and improve safety across the full surgical journey.

We dig into the Cleveland Clinic approach to risk stratification using readmission and mortality data, then translate it into real pathways: virtual preoperative evaluation for low risk patients, focused in-person assessment for high risk patients, and advanced care planning for the most vulnerable. The operational upside is real, too: telemedi...

Welcome to the 2nd episode in our coverage of this year's APSF Stoelting Conference. Discharge feels like a win, but what if it’s only the handoff into the riskiest part of recovery? We challenge the OR to PACU to hospital discharge success mindset and zoom out to the full perioperative journey, where real anesthesia patient safety is measured by what patients can do once they’re back home
 living their lives.

We share powerful ideas from the 2026 APSF Stoelting Conference, including a vision for frictionless surgical care that reduces the burden on patients and clinicians throu...

SOS is more than a maritime relic. It is proof that when people agree on a shared signal, they move faster, coordinate better, and save lives. That is the challenge we wrestle with from the 2026 APSF Stoelting Conference.  Healthcare is full of alarms, monitors, checklists, risk scores, and AI predictions, but we still struggle to agree on which safety signals truly matter, what they mean, and what we are supposed to do next to prevent harm across the perioperative continuum. This is the first part of our series on the 2026 APSF Stoelting Conference.

We dig into a b...

Eye pain in the PACU can trigger a reflex page to ophthalmology, but that reflex is not always the safest or most efficient choice. We provide considerations for perioperative corneal abrasions including why most are superficial epithelial injuries that heal quickly and how an anesthesia-led protocol can deliver fast relief without missing the rare dangerous presentation. If you’ve been unsure when a consult is truly necessary, this conversation gives you a practical, defensible path forward.

We revisit a step-by-step PACU workflow: recognize symptoms early, perform a focused eye exam, assess for visual acuity changes, and use fl...

A patient gets harmed, everyone wants answers, and the system too often responds with blame, silence, or a slow-moving inquiry that arrives years after the frontline has moved on. Today, we are hosting a special podcast takeover show from The Medical Safety Podcast. 

Hosted by Dr. Adam Shehata (former professional pilot turned physician) and Dr. Amir Hamid (anesthetist and emergency medicine physician), The Medical Safety Podcast focuses on how to improve our healthcare system by integrating human factors into systems safety, including medical incident investigation and proactive safety measures. 

This is Episode 10 where Adam and Am...

Your airway cart might look fully stocked, but one quiet change can reshape an entire intubation: a different endotracheal tube brand, a new material formulation, a redesigned cuff, or changes in diameter measurements. We take a close, practical look at endotracheal tube materials and design, and why supply chain instability and product discontinuations can turn a “routine” device into a patient safety risk, particularly for neonates, infants, and other pediatric patients where millimeters matter.

We break down what actually varies between endotracheal tubes that share the same labeled size: PVC construction and the move away from DEHP, chan...

Your first day in anesthesia can be overwhelming with so many numbers, dials, alarms, and decisions that all land at once, and the stakes are high. We sit down with Dr. Lahiru Amaratanga to ask a simple question with big implications for anesthesia patient safety: how can technology make clinicians learn faster without losing the human touch that keeps patients safe?

We dig into practical education innovation, starting with AI coaching and moving toward a “trainee dashboard” that could track real clinical experience like intubations, IV cannulation attempts, and areas that need deliberate practice. We talk about why...

The fastest way to improve anesthesia patient safety is often to stop asking people to be perfect and start redesigning the world they work in. Dr. Alli Bechtel sits down with Dr. Lahiru Amaratunge, a consultant anesthetist in Melbourne, to unpack how human factors engineering, smarter workflows, and better training systems can prevent harm before it happens.

We trace Lahiru’s path from supervising medical students to building the ABCs of Anesthesia YouTube channel and the Anesthesia Collective, creating practical videos and resources that trainees can watch before they step into the operating room. He shares the re...

A dental office can feel low-stakes until the moment it isn’t. We pick up our conversation with Dr. Rita Agarwal to talk about the real-world safety gaps in dental sedation and dental anesthesia, especially for children, and the practical steps that can prevent a routine procedure from turning into a catastrophe.

We walk through the exact questions families can ask before scheduling deep sedation or general anesthesia: What medications are being used? What level of sedation is planned, and how do you know it stays there? Who is responsible for the anesthesia, and is there a de...

A dental chair shouldn’t be a place where safety standards slip, yet that’s the reality Dr. Rita Agarwal lays out with unsettling clarity. We talk through why office-based dental sedation and dental anesthesia can slide into dangerous territory: unclear definitions, uneven training, inconsistent monitoring requirements, and a system that often can’t even tell you how many serious complications occur.

Dr. Agarwal, a pediatric anesthesiologist and longtime patient safety advocate, traces how dentistry and medicine evolved along parallel anesthesia paths, then explains what happens when those paths don’t share the same safeguards. We discuss the trag...

Ketamine for emergency intubation has a reputation for hemodynamic stability, but does the best evidence back that up when your patient is truly sick? Today, we walk through four fresh research summaries that sharpen day-to-day anesthesia patient safety decisions, from airway management in shock and sepsis to the way teams and technology shape outcomes in the OR.

First, we break down a large randomized controlled trial comparing ketamine versus etomidate for tracheal intubation in critically ill adults across U.S. emergency departments and ICUs. Mortality is similar, but ketamine shows more peri-intubation cardiovascular collapse, including hypotension and...

Air embolism is one of those complications that feels impossible right up until it happens fast, quietly, and with life-altering consequences. We walk through the FDA’s 2025 Early Alert on the Watchman access system for left atrial appendage occlusion (LAAO) procedures and connect the dots between device exchange steps, transseptal puncture, and the anesthetic choice that can put patients at risk.

We talk about why the shift toward sedation and spontaneous ventilation in structural heart procedures can increase risk when an access system is open or imperfectly sealed. Negative intrathoracic pressure may create a suction gradient that fa...

Many patients walk into labor and delivery picturing a birth day, not an operating room, and that mismatch is where preventable suffering can start. We sit down with Dr. Ruthi Landau to get practical about cesarean delivery anesthesia, with a focus on patient safety, respectful communication, and what to do when a patient says, “This isn’t comfortable.”

We dig into why setting expectations during neuraxial consent matters, and why active management of labor epidurals is not optional when an urgent intrapartum C-section may be around the corner. We also unpack what the literature keeps showing: epidural top-up...

If you’ve ever heard “it’s just pressure” during a C-section and felt your gut twist, you’re not alone, and it may be a patient safety issue hiding in plain sight. We sit down with Dr. Ruthi Landau, the Virginia Apgar Professor of Anesthesiology and Director of Obstetric Anesthesiology at Columbia University, to get practical about what patients actually feel during cesarean delivery anesthesia and what we can do when those sensations become uncomfortable.

We talk through why labeling sensations as pressure versus pain misses the point, and why the better clinical question is simple: “Is it uncomf...

Pain during cesarean delivery is not “just pressure,” and it is not rare. We dig into why inadequate pain control during C-section remains underrecognized even as patient-reported data suggest it may be one of the most common anesthetic complications in obstetric anesthesia, with consequences that can reach far beyond the operating room including PTSD, postpartum depression, disrupted bonding, and lasting distress about birth.

We walk through what the research has measured so far (conversion to general anesthesia, neuraxial replacement, and intravenous rescue medications) and what those markers can miss when the team does not recognize pain in real...

Eye pain in the PACU can feel like an automatic page to ophthalmology, but it doesn’t have to be. We break down postoperative corneal abrasions on the show today. 

We share practical, clinician-ready guidance drawn from a multidisciplinary PACU corneal abrasion protocol developed with anesthesiology and ophthalmology expertise. You’ll hear exactly what to ask and look for when a patient reports blurry vision or a gritty sensation, the red flag that changes everything (vision loss), and how fluorescein stain plus a cobalt blue light exam can quickly sort a true corneal defect from keratoconjunctivitis or dry e...

“Opioid-sparing” sounds like an automatic win until you look closely at what replaces the opioids. We take on one of the toughest questions in modern anesthesiology: how do we reduce opioid-related harm without trading it for medication interactions, kidney injury, bleeding risk, rebound pain, or poorly controlled postoperative pain?

We break down what individualized multimodal analgesia really means in day-to-day anesthesia practice. That starts before the first dose is ordered, with a preoperative assessment that weighs comorbidities, baseline renal function, hydration status, and potential drug-drug interactions. We also dig into the medication safety side of multimodal protocols, incl...

A virus can feel “far away” right up until it lands in a preop bay with a fever, abdominal pain, and a story that only makes sense weeks later. We walk through what anesthesia, perioperative, and critical care teams need to know about hantavirus, why the incubation period (often 7 to 42 days) complicates detection, and how the Andes virus changes the conversation because it is the only hantavirus known to spread person to person.

We start with the basics that matter at the bedside: common transmission pathways like inhalation of aerosolized particles from rodent droppings, the two major clin...

Twenty-two steps to reach an airway is not a quirky workflow problem, it’s a patient safety problem. We’re turning our attention to a neuro-interventional radiology (Neuro IR) suite where cables, monitors, and a poorly positioned anesthesia machine created a cramped, high-friction non-operating room anesthesia (NORA) environment. Joined by John Edwards, CRNA, we unpack how a real-world quality improvement project at the University of Kentucky Medical Center turned staff frustration into an evidence-based anesthesia workspace redesign.

We start with what triggered the change: frontline clinicians describing barriers to optimal patient care, unsafe ergonomics, and a layout that...

Condensation in an anesthesia circuit looks harmless until it starts skewing flow sensor readings or creating the kind of warm, wet environment where microbes can thrive. We pick up the story after the investigation into moisture and mold concerns in GE operating room ventilators, then move straight into the questions clinicians asked most: which filters matter, how low-flow anesthesia changes the moisture equation, and what “moisture mitigation” actually means at the bedside.

We walk through APSF guidance on filtration, including why a high-quality filter between the expiratory limb and the anesthesia machine is a key defense for keep...

Black particles in a breathing system are the kind of finding that makes every anesthesia professional stop and look twice. We’re sharing what a large health system uncovered after concerns for mold and moisture accumulation surfaced inside certain GE Healthcare anesthesia workstations used in operating rooms, especially during longer cases and in humid conditions. What started with a routine inspection quickly scaled into a broad audit of OR ventilators, a review of internal moisture points, and an urgent push for real-world mitigation.

We walk through what the investigation found, what cultures grew, and the question everyone as...

Delirium, pain, and prolonged ventilation can feel like “expected” bumps in perioperative care until you look closely at the data. We walk through four recent APSF In the Literature reviews and pull out what’s actually actionable for anesthesia patient safety right now, with clear numbers and real-world implications.

First, we dig into a randomized controlled trial of S-ketamine for elderly patients undergoing total hip or total knee arthroplasty under neuraxial anesthesia. With general anesthesia out of the equation, the study reports a notable drop in postoperative delirium, raising practical questions about when S-ketamine belongs in your plan a...

The world has the knowledge to make anesthesia safer, but too often it’s the basics that are missing where the need is greatest. We’re talking about perioperative patient safety in low- and middle-income countries (LMICs), where a smaller share of surgical volume can still carry a massive share of perioperative death and disability. That imbalance isn’t inevitable, and it isn’t solved by one tool or one training course. It changes when systems change. 

We walk through the biggest systemic barriers starting with anesthesia workforce shortages and the downstream effects on access, delays, and confidenc...

Catastrophic neurologic injury after a routine anesthetic is the kind of signal that stops you in your tracks, and that’s exactly why we’re talking about new perioperative recommendations for patients with maternal Venezuelan ancestry. We’ve seen reports of otherwise healthy adults and children who deteriorated after general anesthesia, with sevoflurane appearing repeatedly in the documented events. That pattern has led the American Society of Anesthesiologists and the Society for Pediatric Anesthesia to issue updated guidance aimed at preventing harm while the science catches up. 

We walk through what clinicians need to know about the suspect...

The fastest way to weaken patient safety isn’t a missing checklist, it’s a team that stops trusting each other. We dig into “infinite anesthesia” and the next step, “leading infinitely,” a practical relational leadership approach designed to build psychological safety, empathy, humility, and civility in perioperative care.

We share why anesthesia professionals are uniquely positioned to lead across the full health system: we work at the intersection of surgeons, proceduralists, nurses, and hospital leaders, and we see how small culture signals impact big operational and safety outcomes. You’ll hear how trust-based teamwork can improve clinician well...

Workforce shortages and rising demand are squeezing perioperative teams from every side and that pressure can turn colleagues into rivals. We push back on that mindset and explore a different way to think about the future: “infinite anesthesia,” a long-term approach to anesthesia patient care and anesthesia patient safety that prizes trust, teamwork, and a workplace where every clinician is valued.
 
We share highlights from the APSF Newsletter article “Leading Infinitely in Perioperative Care” and hear directly from author, Dr. Matt Sherrer, on why relational leadership has to extend beyond anesthesia, nursing, and the operating room. When surgeons...

Measles can walk into your OR before the rash ever shows up, and that’s what makes perioperative measles planning so high stakes. We break down the timing that drives everything: incubation, the contagious window from four days before rash onset through four days after, and how recent exposure during an outbreak should change your elective surgery decisions.

We also zoom out to the bigger picture behind today’s resurgence of measles, including declining vaccination rates and travel-related reintroduction. Then we get practical about what anesthesia professionals need at the bedside: how to confirm immunity status, what symp...

A difficult airway is hard enough in a modern hospital. Now imagine managing it on a ship, far from resupply, where “availability supersedes preference” and a device that worked last month might quietly drift out of spec. That’s the tension we unpack while exploring reusable versus single-use airway devices in humanitarian anesthesia and why planning is what protects patients when seconds count.

We’re joined by Matt McGee, a Navy anesthesiologist who served as department head for anesthesiology aboard the USNS Comfort during Continuing Promise 2025. He walks us through what his team saw with reusable airway tools af...

Work stress doesn’t come only from long days and hard cases in the operating room. It also comes from the invisible rules a team lives by: who gets heard, how conflicts get handled, what “efficiency” really means, and whether anyone feels safe enough to speak up. We take on operating room culture change through the lens of pro-social behavior and explain why small, voluntary actions like cooperation, gratitude, and direct support can translate into lower burnout, clearer communication, and stronger patient safety.

We walk through Elinor Ostrom’s Nobel Prize winning core design principles for effective group co...

The fastest way to make an operating room feel unsafe isn’t a broken monitor, it’s a team that stops acting like a team. We dig into pro-social behavior: the small, voluntary actions that support other people and the group, including kindness, cooperation, and gratitude, and why these behaviors can lower cognitive load, strengthen communication, and improve anesthesia patient safety when the schedule gets tight and the stakes are high.

We share highlights from the February 2026 APSF Newsletter feature “Reduce Burnout, Improve Safety and Efficiency: Consider Pro-Social Behavior,” with insights from APSF leader Jeffrey Feldman. He connects...

Cannabis has gone mainstream, but perioperative risk has not improved. THC products are far more potent than they were decades ago, emergency room visits are climbing, and many patients still walk into surgery thinking that it’s safe. We want anesthesia professionals to have a clearer, evidence-informed way to think about cannabis and anesthesia before the next case. 

We open the latest APSF newsletter feature article, “Cannabis and Anesthesia,” and bring in author Trisha Meyer to frame why this topic matters now. Together, we walk through the pharmacology that shows up at the bedside: THC vs CBD, CB1 and...

Postoperative delirium is one of the most common adverse events after surgery for older adults, and it can change a patient’s recovery, independence, and quality of life. We take a practical, evidence-focused look at what anesthesia teams can actually do to support perioperative brain health, using the latest recommendations from the APSF Brain Health Patient Safety Advisory Group.

We walk through the four questions clinicians keep asking at the bedside. First, does intraoperative hypotension drive delirium? We break down why the data is mixed, what mechanisms make hypotension plausible, and why individualized hemodynamic goals with rapid co...

Transfers don’t have to feel like controlled chaos. We break down how to move a critically ill patient from the OR to the ICU with confidence by pairing structured handoffs with disciplined infection prevention—so information moves seamlessly while pathogens hit a dead end.

We start by revisiting the ICU’s influence on anesthesia practice through the story of ARDS and lung-protective ventilation. The shift to 6 ml/kg ideal body weight didn’t just save lungs in the unit; it reshaped intraoperative strategy to reduce ventilator-induced injury for surgical patients. From there, we zoom into the human fa...

A small air bubble, a missed monitor cue, a late call for help—tiny moments that can change everything. We sit down with Dr. Max Feinstein to unpack how real-world anesthesia education builds safer clinicians, why attention is our most precious resource, and how culture—not heroics—prevents harm. From clear talk about morbidity and mortality to practical tactics like just-in-time simulation and curated literature, we map out a grounded approach to training that sticks under pressure.

For new attendings, the leap to autonomy can feel surreal. We talk through imposter syndrome, the virtue of asking for help e...

Curiosity can change a career—and a field. We sit down with pediatric cardiac anesthesiologist and creator Dr. Max Feinstein to trace how a love of ethics, a pandemic schedule, and a phone camera evolved into a mission to make anesthesia safer through clear, accessible education. From the first CA1 walk throughs to high-stakes cardiac cases, Max explains how video demystifies monitors, medications, and moments that raise anxiety for patients and challenge new clinicians.

We dig into the roots of patient safety—why medication errors still matter, how standardized setups and closed-loop communication reduce risk, and where pedi...

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 cras...

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, cont...

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 mate...

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 h...