By MD John G. Brock-Utne
Although near-miss events are thankfully infrequent in anesthesiology, it's necessary to know the way to reply if those events come up. This number of genuine circumstances, 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 overview of capability difficulties and ideas all anesthesiologists might be conversant in. Succinct case shows describe an issue and the answer, with every one write-up concluded via a retrospective research studying even if the answer used was once really the simplest (or in basic terms) selection. different ideas and both passable results are explored, and the best way to support steer clear of difficulties altogether are offered the place attainable. This booklet may perhaps for that reason function both an exceptional overview for the yank Board of Anesthesiology’s oral examination or as a simple and functional means for the reader to realize familiarity with unforeseen difficulties in medical anesthesia.
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Extra resources for Clinical Anesthesia: Near Misses and Lessons Learned
Anesthesiology 1989; 71:449–450. 4. Carson SA, Hubert GD Schriock ED, Buster JE. Hyperglycemia and hyponatremia during operative hysteroscopy with 50% dextrose. Fertil Steril 1989; 51:341–343. 5. D’Agosto J, Ali NMK, Maier D. Absorption of irrigating solutions during hysteroscopy: hysteroscopy syndrome. Anesthesiology 1990;72:379–380. 6. Mangar D. Anaesthetic implications of 32% dextran-70 (Hyskon) during hysteroscopy: hysteroscopy syndrome. Can J Anaesth 1992;39:975–979. 21 Difﬁcult Laryngeal Mask Airway Placement: A Possible Solution A 40-yr-old American Society of Anesthesiologists physical status 1 female with a Mallampati class 2 airway is scheduled for cystoscopy and biopsy of the bladder under general anesthesia.
Torralva PR, Macario A, Brock-Utne JG. Another use of a bronchoscopic swivel adapter. Anesth Analg 1999;88:1187–1188. 2. Robles B, Hester J, Brock-Utne JG. Remember the gum-elastic bougie at extubation. J Clin Anesth 1993;5:329–331. 3. Macintosh RR. An aid to oral intubation. Br Med J 1949;1:28. 13 External Vaporizer Leak During Anesthesia A 45-yr-old patient, American Society of Anesthesiologists physical status 2, is to undergo a removal of a cerebral tumor under general anesthesia. An anesthesia machine (Drager Fabius GS, Telford, PA) and breathing system check are performed before the patient’s arrival.
The anesthesia induction and maintenance is uneventful. 7 mm × 107 cm; Sherwood Medical, St. Louis, MO). Its correct position is veriﬁed by air insufﬂations and slight dilation of the stomach. The patient is taken to the pediatric intensive care unit for recovery. Several hours later, the nurse attempts to manipulate the NG because it seems to be occluded. While she is attempting to move the NG, she is surprised to see a loop of the NG suddenly appear in the mouth. She pushes the NG in again but after that she cannot move the NG up or down.