By John G. Brock-Utne MD PhD FFA(SA)

All anesthesiologists finally face the phobia of a “near miss,” whilst a patient’s lifestyles has been placed in danger. 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 offers eighty rigorously chosen situations that supply the foundation for classes and how you can hinder capability catastrophe. The situations emphasize problem-centered studying and span a wide variety of topics—from a virus of working room an infection (could or not it's the anesthesia equipment?), problems of fiberoptic intubations, and issues of epidural drug pumps, to appearing an pressing tracheostomy for the 1st time, operating with an competitive health practitioner, and what to do while a sufferer falls off the working desk in the course of surgical procedure.

• eighty true-story scientific “near misses” by no means prior to released

• perfect for problem-centered studying

• options, references, and discussions accompany so much circumstances

• 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 booklet, medical Anesthesia: close to Misses and classes discovered (Springer, 2008)

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Extra info for Case Studies of Near Misses in Clinical Anesthesia

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Examination of his airway reveals a maxillary anterior fixed partial denture. ” He has had the bridge for 17 years and never caused any problems. After a routine induction of anesthesia, the patient is easily mask ventilated. A grade-1 view of the larynx is achieved with an atraumatic direct laryngoscope and an endotracheal tube (ETT) placed easily into the trachea. The rest of the anesthesia is uneventful. At the end of the surgery, the patient’s ETT is removed without any problems. He is transported to the postoperative care unit.

2009;109:836–8. Chapter 14 Case 14: An Unusual Capnograph Tracing A 54-year-old (160 cm and 90 kg) woman is scheduled for right front temporal craniotomy for superficial temporal artery to middle cerebral artery bypass. Her past history was significant for bilateral Moyamoya disease, atrial aneurysm, obstructive sleep apnea, hypertension, and hyperlipidemia. You perform a preoperative check of the anesthetic machine (Apollo, Drager Medical, Telford, PA) including a leak test. No abnormalities are found.

1] 14 Case 14: An Unusual Capnograph Tracing 40 20 0 Question What can be the cause of this abnormal waveform? Solution 39 Solution The cause of this midplateau hump was due to a longer than normal sample line combined with a cracked water trap (Apollo Drager Medical, Telford, PA). We have previously published this finding and called it the Dromedary sign [1]. We believe the reason for this is an increased dyssynchrony between the positive pressure phase of mechanical ventilation and the arrival of the end-tidal gas, sampled at the elbow connector, at the gas analyzer.

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