Case Studies of Near Misses in Clinical Anesthesia

Front Matter....Pages i-xvi
Case 1: A Patient with a Mediastinal Mass....Pages 1-3
Case 2: Stick Out Your Tongue....Pages 5-6
Case 3: An Epidural Blood Patch – What Went Wrong?....Pages 7-9
Case 4: A Lack of Communication Leads to a Bad Outcome....Pages 11-14
Case 5: Hyperkalemia During Coronary Artery Bypass Graft....Pages 15-16
Case 6: An Adjuvant to the Cuff-Leak Test....Pages 17-18
Case 7: Acinetobacter baumannii Outbreak in an ICU – Can Our Equipment Be at Fault?....Pages 19-20
Case 8: A Complication with the Use of the Intubating Fiberscope....Pages 21-22
Case 9: Interscalene Block a Concern in Cardiac Patients?....Pages 23-26
Case 10: Epidural Analgesia for Labor – Watch Out....Pages 27-28
Case 11: Past History of Esophagectomy – Any Concern?....Pages 29-31
Case 12: A Case of Myasthenia Gravis....Pages 33-34
Case 13: Where Are My Teeth?....Pages 35-36
Case 14: An Unusual Capnograph Tracing....Pages 37-40
Case 15: A VP Shunt....Pages 41-42
Case 16: Shoulder Surgery – Watch Out!....Pages 43-44
Case 17: An Ambulatory Surgical Patient with No Escort....Pages 45-47
Case 18: A Complication During Laparoscopy....Pages 49-50
Case 19: A Patient with Amyotrophic Lateral Sclerosis....Pages 51-53
Case 20: Repair of a Thoracic Duct....Pages 55-57
Case 21: Occluded Reinforced (Armored) Endotracheal Tube....Pages 59-60
Case 22: A Difficult Nasogastric Tube Insertion....Pages 61-62
Case 23: Antiphospholipid Antibody Syndrome – Any Concern for General Anesthesia?....Pages 63-65
Case 24: An Airway Surprise....Pages 67-68
Case 25: Difficulty with Breathing in the Postoperative Period....Pages 69-71
Case 26: Severe Systemic Local Anesthetic Toxicity....Pages 73-75
Case 27: A Motorcycle Accident with Neck Injury....Pages 77-79
Case 28: Thoracic Incisional Injury....Pages 81-82
Case 29: Bronchospasm – An Unusual Cause....Pages 83-84
Case 30: Post Bariatric Surgery – Any Concerns?....Pages 85-86
Case 31: Valuable Information from an Inplanted Pacemaker....Pages 87-88
Case 32: Allen’s Test in an Anesthetized Patient – Is It Possible?....Pages 89-91
Case 33: A Loss of the Only Oxygen Supply You Have During an Anesthetic....Pages 93-95
Case 34: An Aggressive Surgeon....Pages 97-99
Case 35: A Pharyngeal Mass....Pages 101-103
Case 36: Retained Laps....Pages 105-106
Case 37: A “Code Blue”....Pages 107-108
Case 38: A Complication of Transesophageal Echocardiography....Pages 109-110
Case 39: LMA in Elective Orthopedic Surgery....Pages 111-113
Case 40: What Would You Do?....Pages 115-116
Case 41: Preeclampsia....Pages 117-118
Case 42: A Failed “Test Dose”....Pages 119-120
Case 43: A Simple Cystoscopy with Biopsy....Pages 121-123
Case 44: An Orthopedic Trauma....Pages 125-127
Case 45: Blood in the Endotracheal Tube....Pages 129-131
Case 46: A Longstanding Tracheostomy....Pages 133-135
Case 47: An Airway Problem During Monitored Anesthesia Care....Pages 137-138
Case 48: Is the Patient Extubated?....Pages 139-140
Case 49: A Leaking Anesthesia Machine....Pages 141-142
Case 50: A Most Important Lesson....Pages 143-144
Case 51: Transsphenoidal Resection of a Pituitary Tumor....Pages 145-146
Case 52: Spinal Reconstruction and Fusion in a Chronic Pain Patient....Pages 147-149
Case 53: A Repeat Back Operation in a Patient Who Has Had Postoperative Visual Loss in the Past....Pages 151-153
Case 54: Respiratory Arrest in the Recovery Room....Pages 155-157
Case 55: Bispectral Index – What Does It Mean?....Pages 159-162
Case 56: Neonatal Laparoscopic Surgery....Pages 163-165
Case 57: Total IV Anesthesia....Pages 167-168
Case 58: An ICU Patient....Pages 169-171
Case 59: A New Onset of Atrial Fibrillation in the Recovery Room....Pages 173-175
Case 60: A Rapid Increase in Core Body Temperature....Pages 177-178
Case 61: Prolonged Surgery....Pages 179-181
Case 62: Persistent Intraoperative Hiccups – What to Do?....Pages 183-185
Case 63: Internal Jugular Cannulation....Pages 187-188
Case 64: Endobronchial Foreign Body....Pages 189-190
Case 65: A Cyst in Fourth Ventricle....Pages 191-192
Case 66: Generalized Convulsions After Regional Anesthesia....Pages 193-194
Case 67: Cardiac Arrest in a Prone Patient....Pages 195-197
Case 68: A Short Patient with a High BMI....Pages 199-200
Case 69: Bleeding After Oral Surgery....Pages 201-204
Case 70: Selecting the Right Size Double Lumen Tube....Pages 205-206
Case 71: A Low Normal Preoperative Blood Glucose Level....Pages 207-208
Case 72: Things to Remember When You Change a Cordis Catheter to a Triple Lumen....Pages 209-210
Case 73: An Intraoperative Malfunctioning Vaporizer....Pages 211-213
Case 74: An Abnormal EKG First Discovered in the Operating Room....Pages 215-217
Case 75: A Cardiac Arrest in ICU....Pages 219-220
Case 76: A Severe Case of Metabolic Acidosis....Pages 221-222
Case 77: Bunionectomy Under Both General and Regional Anesthesia....Pages 223-224
Case 78: Now What Would You Do?....Pages 225-226
Case 79: A Strange Case....Pages 227-228
Case 80: A Chronic Pain Patient....Pages 229-230
Back Matter....Pages 231-236