Page 38 - Part 1 Anesthesiology Common Risk Issues

SVMIC Anesthesiology: Common Risk Issues

short period of time followed by a larger dose over a 24-hour

period. There had been no communication of this plan to the
CRNA and no notation of this in the anesthesia plan. Thus, it

appeared that the CRNA gave too much volume of morphine
anesthetic into the spinal cord of the 11-month-old baby with a

devastating result. The baby was unable to move his legs post-
operatively.

Good communication between the anesthesiologist and the

CRNA is extremely important and should be documented. Some
suggestions to ensure good communication are:

• Review the pre-anesthesia evaluation and communicate
with the CRNA regarding the anesthesia plan

• Ensure that you, the anesthesiologist, are present in the
OR upon induction, key portions of the procedure as well

as emergence

• Insist that CRNAs communicate to you immediately
regarding all unusual events and readings

• Be approachable

• Have written protocols delineating the responsibilities and

duties of the CRNA

• Consider having an emergency or crisis checklist available

at each OR anesthesia station

• Practice emergency response with mock crisis situations

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