By John G. Brock-Utne MD PhD FFA(SA)
Residents, fellows, and training qualified registered nurse anesthetists will enjoy the retelling of those genuine close to misses, the recommendations selected on the time, and a retrospective research of these recommendations that incorporates guidance for a way the issues might have been refrained from altogether or resolved in a different way. a very good research relief for the yank Board of Anesthesiology oral examination and an invaluable instructing software for school, because close to misses comparable to those are particularly infrequent and except studying approximately them, there particularly isn't any method to be ready to effectively deal with such crises. As such, even skilled anesthesiologists and CRNAs will locate this to be a necessary purchase.
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Extra resources for Clinical Anesthesia: Near Misses and Lessons Learned
7. Pousman RM, Koch SM. Endotracheal tube obstruction after orogastric tube placement. Anesthesiology 1997;87:1247–1248. 8. Au-Truong X, Lopez G, Joseph NJ, Ramez Salem M. A case of a nasogastric tube knotting around a tracheal tube: detection and management. Anesth Analg 1999;89:1583–1584. 19 An Unusual Cause of Difﬁcult Tracheal Intubation A 45-yr-old, 80 kg Sikh man from India is admitted for repair of scapholunate dislocation. His past medical history and physical exam is unremarkable. He is classiﬁed as American Society of Anesthesiologists physical status 1.
Recommendation The ring ﬁnger may be a more appropriate site for the pulse oximeter, rather than the index ﬁnger. This avoids possible corneal abrasion when the patient rubs his/her eye in the immediate postoperative period (2,3). References 1. White E, Crosse MM. The aetiology and prevention of peri-opeative corneal abrasions. Anaesthesia 1998;53:157–161. 2. Brock-Utne JG, Botz G, Jaffe RA. Perioperative corneal abrasions. Anesthesiology 1992;77:221. 3. Brock-Utne JG. The aetiology and prevention of peri-opeative corneal abrasion.
Somehow, the IV was cut and a knot was made either before or after the IV cut. It is of course possible that the tucking of the right arm with a sheet could have made a knot in the IV tubing and the surgeon later cut the IV proximately to the knot. Discussion In a previous publication, the problem with the “hidden” IV was highlighted (1). The term hidden IV is used when the surgeon requests one or both arms to be tucked beside the anesthetized patient’s body during surgery. If the arm or arms have an IV in them, then the IV is hidden from view.