By MD John G. Brock-Utne
Although near-miss occasions are thankfully infrequent in anesthesiology, it's necessary to know the way to reply if those events come up. This number of real instances, compiled from the author’s thirty-five plus years of perform in significant metropolitan hospitals within the usa, Norway, and South Africa, is a wonderful assessment of power difficulties and options all anesthesiologists will be conversant in. Succinct case shows describe an issue and the answer, with each one write-up concluded via a retrospective research studying even if the answer used used to be really the simplest (or merely) selection. different ideas and both passable results are explored, and how you can support steer clear of difficulties altogether are provided the place attainable. This ebook may possibly for that reason function both a very good assessment for the yankee Board of Anesthesiology’s oral examination or as a simple and functional means for the reader to realize familiarity with unforeseen difficulties in scientific anesthesia.
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Extra resources for Clinical Anesthesia: Near Misses and Lessons Learned
He has failed medical management. He is 84 kg and 5′10″ tall. He has had one previous general anesthetic for an acute appendix at age 10. Otherwise, his medical history and physical exam is unremarkable. He is presently not taking any medication and has no known allergies to medicines. He has a normal white cell count and his Hb is 14 mg%. After sedation with midazolam 2 mg IV, he is taken to the operating room, where a routine general anesthetic is induced uneventfully. Tracheal intubation (grade 1 view) is done atraumatically on the ﬁrst attempt after ensuring that the patient is fully paralyzed with a nerve stimulator (vecuronium 7 mg).
A hairy problem. Anesth Analg 1991;72:839. 2. Bhogal HS, Gan TJ. Awareness of Sikh custom of restraining a beard with a cord leading to possible airway problems. Anesth Analg 1999;1586. 3. Brock-Utne JG, Brodsky JB, Haddow GR. Bearded Sikhs and tracheal intubation Anesth Analg 2000;90:494. 4. Bhogal HS. Bearded Sikhs and tracheal intubation. Anesth Analg 2000;90:494. 20 Pulmonary Edema After Abdominal Laparoscopy A 69-yr-old, 50 kg woman with pelvic pain is admitted for laparoscopic carbon dioxide laser lysis of pelvic adhesions.
The problem in a previously reported case was that when we examined the 20-G IV from the IV bag to its insertion, we found that the IV line was cut 30 cm from where 20-G needles were placed in the 22 9. The Case of the “Hidden” IV 23 vein (1). Interestingly, the distal end attached to the 20-G catheter had a tight knot, while the proximal end was completely open. ” We could not ascertain how this happened, as all concerned denied any involvement. Somehow, the IV was cut and a knot was made either before or after the IV cut.