Page 25 - Part 1 Anesthesiology Common Risk Issues

SVMIC Anesthesiology: Common Risk Issues

Adverse anesthesia events can occur despite the sophisticated

monitors in use. Many adverse events should not occur but do
because alarms were never activated, were silenced during the

procedure, or had been silenced at the end of the prior case
and not reactivated (Be aware that some machines do not

automatically reset the alarm). Do not neglect pulse oximeter
and CO2 alarms. The ASA standards require that alarms be

audible to the anesthesiologist or member of the anesthesia
care team.

Difficulties with a patient’s airway is one of the

anesthesiologist’s/CRNA’s top concerns causing serious
complications with the possibility of death or permanent brain

damage. Difficult airways were encountered on induction in
67 percent of cases, during surgery in 15 percent of cases,

on extubation in 12 percent, and in 5 percent of cases during
recovery.9 It is important to mention that death and permanent

brain damage from difficult intubation at induction of anesthesia
has declined since the adoption of the ASA practice guidelines

for management of difficult airway.

Dental injuries remain one of the most frequently encountered

adverse events in anesthesia. Performing and documenting a
dental exam and including dental injury as an identified risk in

your informed consent discussion may be effective in mitigating
the exposure. This process can be especially important with

patients who have had cosmetic dentistry procedures.

Anesthesia records are, by necessity, abbreviated and concise.
That leaves little room for legible, detailed descriptions of

unusual events. If something out of the ordinary happens

9 http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1942519

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