By John G. Brock-Utne
All anesthesiologists finally face the terror of a “near miss,” whilst a patient’s lifestyles has been positioned at risk. studying from the adventure is essential to professionalism and the continued improvement of craftsmanship. Drawing on forty-plus years of perform in significant metropolitan hospitals within the usa, Norway, and South Africa, John Brock-Utne, MD provides eighty rigorously chosen circumstances that supply the foundation for classes and find out how to hinder power catastrophe. The situations emphasize problem-centered studying and span a extensive variety of topics—from a pandemic of working room an infection (could it's the anesthesia equipment?), complications of fiberoptic intubations, and issues of epidural drug pumps, to acting an pressing tracheostomy for the 1st time, operating with an competitive doctor, and what to do whilst a sufferer falls off the working desk in the course of surgery. 80 true-story scientific “near misses” by no means earlier than released, perfect for problem-centered studying, ideas, references, and discussions accompany so much instances, wealthy foundation for educating discussions either in or out of the working room, settings contain subtle in addition to rudimentary anesthetic environments, enhances the author’s different case publication, scientific Anesthesia: close to Misses and classes realized (Springer, 2008).
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Extra resources for Case Studies of Near Misses in Clinical Anesthesia
Messina M. Paolucci E, Casoni G, Gurioli C and Poletti V. A case of severe dyspnea and an unusual bronchoscopy. The Chilaiditi Syndrome. Respiration. 2008;76:216–7. Sun N, Singh VM, Nguyen J, Brock-Utne JG. Interscalene block in a patient with previous open cardiac surgery (Submitted for publication, 2011). ) is requesting an epidural for labor pain. She is a para 3 and has had epidurals in the past without any problem. Previous medical history is noncontributory and she has had no surgeries.
1999;33:782–5. Nzerue CM, Falana B. Refractory hyperkalaemia associated with use of Epsilon-Aminocaproic Acid during coronary bypass in a dialysis patient. Nephrol Dial Transplant. 2002;17:1150–1. Chapter 6 Case 6: An Adjuvant to the Cuff-Leak Test You have just finished a long laparoscopic nephrectomy in a 50-year-old woman (5 ft 6 in. and 95 kg). She is the donor to her brother. The operation has lasted 7 h. Since she has been in Trendelenburg position for most of that time, her face and neck are very swollen.
However, with the onset of positive pressure mechanical ventilation, the pressure gradient across the leak reverses. The leak is now outward, thereby eliminating the dilution effect. The result is a late expiratory plateau prior to the normal down slope of the capnograph waveform. Since CO2 was not used during the preoperative machine check, the problem was not discovered. 2 Biphasic, dual plateau waveform. Reprinted, with permission, from Jaffe et al.  20 0 40 14 Case 14: An Unusual Capnograph Tracing Recommendation This case illustrates the need to be able to deduce the cause of an abnormal capnography tracing.