Bio

Clinical Focus

  • Anesthesiology

Academic Appointments

Professional Education

  • Medical Education: Albert Einstein College of Medicine (1994) NY
  • Internship: Icahn School of Medicine at Mount Sinai Pediatric Residency NY
  • Residency: Massachusetts General Hospital MA
  • Fellowship: Boston Children's Hospital Dept of Anesthesiology MA
  • MBA, Duke University, Fuqua School of Business (2013)
  • Board Certification: American Board of Anesthesiology, Anesthesiology (1999)
  • Board Certification, Anesthesiology, American Board of Anesthesiology (2009)
  • Board Certification: American Board of Anesthesiology, Pediatric Anesthesia (2013)
  • Board Certification, Anesthesiology, American Board of Anesthesiology (2019)

Contact

  • Anesthesia Department 300 Pasteur Dr Rm H3580 MC 5640 Stanford, CA 94305
    • Tel: (650) 723-6412
    Fax: (650) 725-8544

Publications

All Publications

  • COVID-19 Preoperative Assessment and Testing: From Surge to Recovery. Annals of surgery Lu, A. C., Schmiesing, C. A., Mahoney, M., Cianfichi, L., Semple, A. K., Watt, D., Fischer, S., Wald, S. H. 2020

    View details for DOI 10.1097/SLA.0000000000004124

    View details for PubMedID 32541233

  • Asymptomatic SARS-CoV-2 Transmission from Community Contacts in Healthcare Workers. Annals of surgery Graham, L. A., Maldonado, Y. A., Tompkins, L. S., Wald, S. H., Chawla, A., Hawn, M. T. 2020

    View details for DOI 10.1097/SLA.0000000000003968

    View details for PubMedID 32487801

  • COVID-19: Common Critical and Practical Questions. Anesthesia and analgesia Lu, A. C., Sastry, S. G., Wong, B. J., Deng, A., Wald, S. H., Pearl, R. G., Tsui, B. C. 2020

    View details for DOI 10.1213/ANE.0000000000004938

    View details for PubMedID 32366770

  • N95 Respirator Alternatives And Conservation Strategies. Anesthesia and analgesia Wong, B. J., Lu, A. C., Tarlow, B. D., Tompkins, L. S., Chawla, A., Pearl, R. G., Wald, S. H. 2020

    View details for DOI 10.1213/ANE.0000000000005134

    View details for PubMedID 32701549

  • Determination of Length of Time for "Post-Aerosol Pause" for Patients Under Investigation or Positive for COVID-19. Anesthesia and analgesia Wald, S. H., Arthofer, R., Semple, A. K., Bhorik, A., Lu, A. C. 2020

    View details for DOI 10.1213/ANE.0000000000004921

    View details for PubMedID 32345854

    View details for PubMedCentralID PMC7202114

  • A Framework for Prioritizing Head and Neck Surgery during the COVID-19 Pandemic. Head & neck Topf, M. C., Shenson, J. A., Holsinger, F. C., Wald, S. H., Cianfichi, L. J., Rosenthal, E. L., Sunwoo, J. B. 2020

    Abstract

    The COVID-19 pandemic has placed an extraordinary demand on the United States healthcare system. Many institutions have cancelled elective and non-urgent procedures to conserve resources and limit exposure. While operational definitions of elective and urgent categories exist, there is a degree of surgeon judgment in designation. In the present commentary, we provide a framework for prioritizing head and neck surgery during the pandemic. Unique considerations for the head and neck patient are examined including risk to the oncology patient, outcomes following delay in head and neck cancer therapy, and risk of transmission during otolaryngologic surgery. Our case prioritization criteria consist of four categories: urgent - proceed with surgery, less urgent - consider postpone >30?days, less urgent - consider postpone 30-90?days, and case-by-case basis. Finally, we discuss our preoperative clinical pathway for transmission mitigation including defining low-risk and high-risk surgery for transmission and role of preoperative COVID-19 testing. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1002/hed.26184

    View details for PubMedID 32298036

  • Resuscitation on collapsed healthcare worker while taking care of suspected or confirmed COVID patient: Questions and Answers. Anesthesia and analgesia Lu, A. C., Wong, B. J., Sastry, S. G., Wald, S. H., Pearl, R. G., Tsui, B. C. 2020

    View details for DOI 10.1213/ANE.0000000000005136

    View details for PubMedID 32701548

  • Commentary: How Should Hospitals Respond to Surgeons' Requests to Schedule Overlapping Surgeries? Neurosurgery Morris, A. J., Mello, M. M., Sanford, J. A., Green, R. B., Wald, S. H., Kadry, B., Macario, A. 2018; 82 (4): E91?E98

    View details for PubMedID 29351634

  • Commentary: How Should Hospitals Respond to Surgeons' Requests to Schedule Overlapping Surgeries? NEUROSURGERY Morris, A. J., Mello, M. M., Sanford, J. A., Green, R. B., Wald, S. H., Kadry, B., Macario, A. 2018; 82 (4): E91?E97

    View details for DOI 10.1093/neuros/nyx627

    View details for Web of Science ID 000439686300003

  • Overlapping Surgery: A Case Study in Operating Room Throughput and Efficiency. Anesthesiology clinics Morris, A. J., Sanford, J. A., Damrose, E. J., Wald, S. H., Kadry, B., Macario, A. 2018; 36 (2): 161?76

    Abstract

    A keystone of operating room (OR) management is proper OR allocation to optimize access, safety, efficiency, and throughput. Access is important to surgeons, and overlapping surgery may increase patient access to surgeons with specialized skill sets and facilitate the training of medical students, residents, and fellows. Overlapping surgery is commonly performed in academic medical centers, although recent public scrutiny has raised debate about its safety, necessitating monitoring. This article introduces a system to monitor overlapping surgery, providing a surgeon-specific Key Performance Indicator, and discusses overlapping surgery as an approach toward OR management goals of efficiency and throughput.

    View details for DOI 10.1016/j.anclin.2018.01.002

    View details for PubMedID 29759280

  • Into the Wilderness?: The Growing Importance of Nonoperating Room Anesthesia Care in the United States. Anesthesia and analgesia Lu, A. C., Wald, S. H., Sun, E. C. 2017; 124 (4): 1044?46

    View details for PubMedID 28319544

  • Unexpected Profound Hypotension During Sinus Surgery SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE Wang, C., Myo, C. C., Kuchta, K., Wald, S. H. 2012; 7 (1): 54-60

    View details for DOI 10.1097/SIH.0b013e318223d755

    View details for Web of Science ID 000300414000010

    View details for PubMedID 21937964

  • Economic Advantages to a Distraction Decision Tree Model for Management of Neonatal Upper Airway Obstruction PLASTIC AND RECONSTRUCTIVE SURGERY Kohan, E., Hazany, S., Roostaeian, J., Allam, K., Head, C., Wald, S., Vyas, R., Bradley, J. P. 2010; 126 (5): 1653-1665

    View details for DOI 10.1097/PRS.0b013e3181ef8e82

    View details for Web of Science ID 000283844700030

  • Dexmedetomidine and ketamine for fiberoptic intubation in a child with severe mandibular hypoplasia JOURNAL OF CLINICAL ANESTHESIA Iravani, M., Wald, S. H. 2008; 20 (6): 455-457

    Abstract

    A 6-year-old girl with Treacher Collins syndrome presented for implantation of a hearing device. The patient was developmentally delayed and had severe micrognathia. After induction of anesthesia with dexmedetomidine and ketamine, the patient tolerated the introduction of a flexible fiberoptic bronchoscope without any change in respiration, and intubation was achieved easily.

    View details for DOI 10.1016/j.jclinane.2008.03.012

    View details for Web of Science ID 000260134200011

    View details for PubMedID 18929288

  • Successful blood conservation during craniosynostotic correction with dual therapy using procrit and cell saver JOURNAL OF CRANIOFACIAL SURGERY Krajewski, K., Ashley, R. K., Pung, N., Wald, S., Lazareff, J., Kawamoto, H. K., Bradley, J. P. 2008; 19 (1): 101-105

    Abstract

    Craniosynostotic correction typically performed around infant physiologic nadir of hemoglobin (approximately 3-6 months of age) is associated with high transfusion rates of packed red blood cells and other blood products. As a blood conserving strategy, we studied the use of 1) recombinant human erythropoietin or Procrit (to optimize preoperative hematocrit) and 2) Cell Saver (to recycle the slow, constant ooze of blood during the prolonged case).UCLA Patients with craniosynostosis from 2003-2005 were divided into 1) the study group (Procrit and Cell Saver) or 2) the control group (n = 79). The study group 1) received recombinant human erythropoietin at 3 weeks, 2 weeks, and 1 week preoperatively and 2) used Cell Saver intraoperatively. Outcomes were based on morbidities and transfusion rate comparisons.The 2 groups were comparable with regards to age (5.66 and 5.71 months), and operative times (3.11 vs 2.59 hours). In the study group there was a marked increase in preoperative hematocrit (56.2%). The study group had significantly lower transfusions rates (5% vs 100% control group) and lower volumes transfused than in the control group (0.05 pediatric units vs 1.74 pediatric units). Additionally, of the 80% of patients in the study group who received Cell Saver blood at the end of the case, approximately 31% would have needed a transfusion if the recycled blood were unavailable.Our data showed that for elective craniosynostotic correction, successful blood conserving dual therapy with Procrit and Cell Saver might be used to decrease transfusion rates and the need for any blood products.

    View details for Web of Science ID 000252619900016

    View details for PubMedID 18216672

  • Scenario and checklist for airway rescue during pediatric sedation. Simulation in healthcare Chen, M. I., Edler, A., Wald, S., Dubois, J., Huang, Y. M. 2007; 2 (3): 194-198

    View details for DOI 10.1097/SIH.0b013e3181461b60

    View details for PubMedID 19088623

  • Continuous monitoring of dynamic pulmonary compliance enables detection of endobronchial intubation in infants and children ANESTHESIA AND ANALGESIA Mahajan, A., Hoftman, N., Hsu, A., Schroeder, R., Wald, S. 2007; 105 (1): 51-56

    Abstract

    Auscultation of breath sounds is used routinely to confirm tracheal placement of endotracheal tubes (ETT). In infants and children, this method is limited by the conduction of breath sounds bilaterally, despite endobronchial intubation. Although several methods of detecting endobronchial intubation have been described, none is both simple and reliable. In this investigation, we determined whether changes in pulmonary compliance and airway pressures, measured using continuous side stream spirometry, can reliably detect endobronchial intubation in pediatric patients.Forty patients aged 1 month to 6 years were included. After endotracheal intubation the ETT was incrementally advanced as two observers monitored breath sounds and spirometry (Pressure-Volume Loops). Changes in pulmonary compliance, peak inspiratory pressure, or auscultation were reported, at which point ETT position was confirmed by fiberoptic bronchoscopy.Endobronchial intubation decreased measured pulmonary compliance by 45 +/- 11% (mean +/- sd; P < 0.001, Range 26%-66%) and increased peak airway pressures by 26 +/- 17% (mean +/- sd; P < 0.001, Range 0-87). Changes in peak airway pressures were smaller and more variable when compared to changes in compliance. Breath-sound auscultation failed to detect endobronchial intubation in 7.5% of cases.Pulmonary compliance changes are a sensitive and an accurate indicator of endobronchial intubation in infants and children. Both increased peak airway pressures and changes in breath sounds are less sensitive indicators of endobronchial intubation.

    View details for DOI 10.1213/01.ane.0000268119.55909.b4

    View details for Web of Science ID 000247444800016

    View details for PubMedID 17578956

  • Experience with the Arndt paediatric bronchial blocker BRITISH JOURNAL OF ANAESTHESIA Wald, S. H., Mahajan, A., Kaplan, M. B., Atkinson, J. B. 2005; 94 (1): 92-94

    Abstract

    Previously reported techniques for single lung ventilation in children have failed to provide consistent, single lung ventilation with relative ease and reliability. We report our experience with the use of a new device, the Arndt 5 French (Fr) paediatric endobronchial blocker, for single lung ventilation in a series of 24 children. We were able to achieve single lung ventilation in 23 of the 24 patients (aged 2-16 yr). Placement required approximately 5-15 min. Attempts at placement were aborted in one patient who was unable to tolerate even short periods of apnoea because of lung pathology. Although it has some limitations, our experience suggests that the paediatric bronchial blocker can be used as a consistent, safe method of single lung ventilation in most young children.

    View details for DOI 10.1093/bja/aeh292

    View details for Web of Science ID 000226415700016

    View details for PubMedID 15486004

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