By John G. Brock-Utne
All anesthesiologists ultimately face the terror of a “near miss,” while a patient’s lifestyles has been positioned at risk. studying from the adventure is important to professionalism and the continued improvement of workmanship. Drawing on forty-plus years of perform in significant metropolitan hospitals within the usa, Norway, and South Africa, John Brock-Utne, MD provides eighty conscientiously chosen circumstances that supply the foundation for classes and easy methods to hinder capability catastrophe. The circumstances emphasize problem-centered studying and span a large variety of topics—from a deadly disease 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 physician, 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 ahead of released, excellent for problem-centered studying, concepts, references, and discussions accompany such a lot situations, wealthy foundation for instructing discussions either in or out of the working room, settings comprise refined in addition to rudimentary anesthetic environments, enhances the author’s different case e-book, medical Anesthesia: close to Misses and classes realized (Springer, 2008).
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Additional info for Case Studies of Near Misses in Clinical Anesthesia
Failure to do so can prove disastrous for patients. Bernards AT, Harinch HIJ, Dijkshoorn L, et al. Persistent Acinetobacter baumannii? Look inside your medical equipment. Infect Control Hosp Epidemiol. 2004;25:1002–4. Huagn JKC, Shah EF, Vinokumar N, et al. The Bair Hugger patient warming system in prolonged vascular surgery: an infection risk? Crit Care. 2003;7:13–6. Gjolai MP, Ahlbrand S, Yamout IM, Armstrong D, Brock-Utne JG. Don’t forget to change the Bair Hugger filter. Anesthesiology. 2009, A1168.
A simple method to identify an external vaporizer leak (the “sniff” method). Anesth Analg. 2005;101:606–7. Robles B, Hester J, Brock-Utne JG. Remember the gum-elastic bougie at extubation. J Clin Anesth. 1993;5:329–31. Chapter 7 Case 7: Acinetobacter baumannii Outbreak in an ICU – Can Our Equipment Be at Fault? An outbreak of a multidrug-resistant Acinetobacter baumannii has occurred in your hospital ICU. One small child has died and five other patients are on ventilator support. Hygienic measures are intensified.
Questions Now what will you do? Cut the catheter? G. 1007/978-1-4419-1179-7_8, © Springer Science+Business Media, LLC 2011 21 22 8 Case 8: A Complication with the Use of the Intubating Fiberscope Solutions The first thing to do is to reinsert the fiberscope over the catheter into the ETT to try and elucidate the problem. You now see that the catheter has gone beyond the ETT and is lying in the trachea. You cannot see the tip. The catheter can still not be removed. You wonder if the catheter has migrated up between the ETT and the trachea and is stuck there by the ETT’s cuff that is now blown up.