A remarkable safety story runs through regional anesthesia, from the era of blind needle placement to a modern practice guided by real-time ultrasound, lipid rescue, and reliable team checklists. We walk through the key milestones that cut complications, accelerated block onset, and lowered conversion to general anesthesia, while keeping a clear eye on the hazards that remain. Along the way, we explain how a simple seven-point timeout helps prevent wrong-sided blocks and why ultrasound has reshaped dosing, local anesthetic spread confirmation, and failure rates.

We also dig into the numbers around local anesthetic systemic toxicity and neurologic injury, translating data into everyday decisions at the bedside. You’ll hear how improved dosing protocols, reduced volumes with ultrasound guidance, and rapid access to lipid therapy drive cardiac toxicity toward zero. We unpack the real contributors to failed blocks—anatomic variation, communication barriers, obesity, surgical factors, and experience—and share practical, high-yield steps for safer performance, from short-bevel needle selection to injection pressure monitoring and clear patient counseling.

Looking forward, we explore the next wave of tools transforming the block room: 3D and 4D ultrasound for richer visualization, needle tip tracking for faster and steadier trajectories, and pressure monitoring that warns before harm. We spotlight how AI could assist with ultrasound interpretation, trajectory planning, and complication prediction, while wearables and high-fidelity simulation extend safety beyond the procedure to early detection and better training. If you care about preventing never events, reducing LAST, and building a resilient regional anesthesia workflow, this conversation lays out what works now and what’s coming next.

Enjoyed the insights? Subscribe, share with a colleague, and leave a review to help more clinicians advance patient safety.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/290-from-blind-needles-to-ultrasound-the-safety-revolution-in-regional-anesthesia/

© 2026, The Anesthesia Patient Safety Foundation

A single syringe swap should never decide a patient’s fate. We pull back the curtain on forty years of anesthesia medication safety to show what truly works—then tackle the hard part: getting proven safeguards into every OR, every time. From look-alike vial hazards to standardization that actually sticks, this conversation blends frontline realities with practical steps leaders can implement now.

We dig into the high-stakes TXA wrong-drug, wrong-route crisis and explain why eliminating vials and moving to ready-to-administer IV bags is a must. Along the way, we unpack new FDA label warnings, the APSF–ISMP joint recommendations, and the forcing functions that prevent catastrophes, including NRFit for neuraxial routes and barcode verification at the point of care. We also surface quieter threats—vial coring, variable concentrations, and chaotic storages—and show how color-coded, readable labels and organized carts reduce cognitive load when seconds matter.

Opioid safety gets equal focus. We connect preoperative risk assessment, multimodal analgesia, and smart postoperative monitoring to reduce opioid-related harm without compromising comfort. Technology has matured too: AI-driven clinical decision support can flag dosing and drug-choice risks in real time, but only if woven into workflows that clinicians trust. Throughout, we return to the implementation gap: success depends on leadership support, supply chain alignment, failure mode analysis, transparent reporting, and peer support that sustains a just culture.

If you care about safer anesthesia—standardized labels and concentrations, prefilled syringes, organized storage, barcode checks, and a culture that learns—this is your playbook. Listen, share with your team, and help push your institution from knowing to doing. Subscribe, leave a review, and tell us which safeguard you’ll champion next.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/289-forty-years-of-anesthesia-medication-safety-what-works-and-whats-next/

© 2026, The Anesthesia Patient Safety Foundation

Seconds define outcomes in the OR, and medication safety lives in those seconds. We take you inside four decades of work by the Anesthesia Patient Safety Foundation to show how our field shifted from relying on vigilance to building systems that make the right action the easy action. Along the way, guest contributor, Dr. Elizabeth Rebello, shares why standardization, technology, and culture are not buzzwords but lifelines when a single clinician must select, prepare, and administer drugs under pressure.

We break down the STPC framework born from the 2010 Stoelting Conference—standardization, technology, pharmacy/pre-filled/pre-mixed, and culture—and translate it into real steps: standardized concentrations for high-alert medications, removal of concentrated lethal agents from the OR, barcode-based identification before draw-up or administration, and smart infusion pumps with user-friendly drug libraries. You’ll hear how prefilled syringes, automated dispensing, and clinical pharmacist integration reduce prep errors and free up attention when it matters most.

The story moves forward with the 2018 focus on drug safety profiles and the stubborn challenge of shortages. We explore actionable ideas: building a standing shortage committee, communicating substitutions fast, simplifying carts and labels when suppliers change, and embracing multimodal analgesia.

By the end, you’ll have a clear map of what to implement now—printed labels, prefilled syringes, smart-pump integration with your anesthesia record—and what to champion next across your institution. Subscribe and share with a colleague who leads in the OR. Then tell us: which safety step will you push across the finish line this year?

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/288-forty-years-of-perioperative-medication-safety-progress/

© 2026, The Anesthesia Patient Safety Foundation