Case Studies of Near Misses in Clinical Anesthesia
All anesthesiologists eventually face the fear of a “near miss,” when a patient’s life has been put at risk. Learning from the experience is crucial to professionalism and the ongoing development of expertise. Drawing on forty-plus years of practice in ma
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John G. Brock-Utne
Case Studies of Near Misses in Clinical Anesthesia
John G. Brock-Utne, MD, PhD, FFA(SA) Professor of Anesthesia Stanford University Medical Center Stanford, CA 94305-5640, USA [email protected]
ISBN 978-1-4419-1178-0 e-ISBN 978-1-4419-1179-7 DOI 10.1007/978-1-4419-1179-7 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011931890 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
For the next generation: Matthew B. Brock-Utne Tobias J. Brock-Utne Anders C. Brock-Utne Jasper L. Brock-Utne Stefan S. Brock-Utne
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Foreword
The anesthetic care of most of our patients often seems routine. For the majority, a preoperative evaluation management plan is made and followed, and the anesthesia and surgery proceeds as planned. Anesthesiologists do not like surprises! But, sometimes (and thankfully not often) the case does not follow the script, and unanticipated events occur. Patients have idiosyncratic responses to medications, or experience surgical or anesthetic misadventures that lead to changes in vital signs or worse. These events are few and far between, and if you have not witnessed them previously, you might not consider some of the more unusual causes for these presentations. John Brock-Utne has once again collected a series of such “rare” events. Each case discussion considers the presentation, his diagnosis, and then his approach to management. In each instance, catastrophe was avoided. Every case in this book is real, and similar events could occur tomorrow to patients under the care of the reader. It is the early recognition of these “near miss” episodes and the “lessons learned” in managing them that make this book so important. Dr. BrockUtne’s many years of experience, his interesting way of presenting the case scenarios, and his practical no-frills approach to m
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