Avoiding Common Anesthesia Errors

This pocket book succinctly describes 215 common, serious errors made by attendings, residents, fellows, CRNAs, and practicing anesthesiologists in the practice of anesthesia and offers practical, easy-to-remember tips for avoiding these errors. The book can easily be read immediately before the start of a rotation or used for quick reference. Each error is described in a quick-reading one-page entry that includes a brief clinical scenario, a short review of the relevant physiology and/or pharmacology, and tips on how to avoid or resolve the problem. Illustrations are included where appropriate. The book also includes important chapters on human factors, legal issues, CPT coding, and how to select a practice.

Table of Contents:
AIRWAY AND VENTILATION Basics Advanced Never neglect the basics of airway management Basics of airway management- Part II (Tips and Tidbits) Consider PEEP Advanced: A variety of techniques provide acceptable anesthesia for awake intubation of the airway: ultimately, the most important factors are operator experience and adequate time Special Cases: A high inspired concentration of oxygen is contraindicated in certain circumstances Remember that there are special considerations involved with both intubation and chronic airway management of burn patients Problem solving: Always troubleshoot an increase in peak airway pressure Plan for an airway fire with every head and neck case Know how to perform a cricothyroidotomy Perioperative Issues Don'ts: Do not overinflate the cuff of the endotracheal tube Don't under represent the risks associated with the use of a laryngeal mask airway Do not be intimidated by the placement and use of double-lumen endotracheal tubes Do not underestimate the difficulty of reintubating a patient who has undergone carotid endarterectomy or cervical spine surgery Do not start the airway management of a Ludwig angina patient until personnel and equipment for a definitive (surgical) airway are assembled LINES AND ACCESS Basics:Remember that the IV start is your first chance to make a favorable impression on the patient Never use an intravenous line without palpating and inspecting it visually Use of ultrasound guidance for cannulation of the central veins improves success rates, decreases number of attempts, and lowers complication rates Central Lines: Central line placement: never neglect the basics Approach the use of a pulmonary artery catheter with caution Avoid technique-related central venous catheter complications by using modern tools Don'ts: Don't overflush lines Do not use the subclavian vein for central access of any type in a patient planned for dialysis Errors: Remember that inadvertent intra-arterial injection is not rare Avoid errors in invasive blood pressure measurement Remember that loss of a patent hemodialysis fistula in the perioperative period is a serious event for the patient and requires immediate communication with the surgeons FLUIDS, RESUSCITATION, AND TRANSFUSION Fluids: Hypertonic saline: the "solution" to the solution problem? Remember that the synthetic colloid solutions have distinct properties and risk/benefit ratios Resuscitation: Protect the kidneys, not the "UOP" Do not treat lactic acidosis with bicarbonate Consider the use of tris-hydroxymethyl aminomethane (THAM)to treat refractory or life-threatening metabolic acidosis Use the principles of "damage control anesthesia" in the care of the massively bleeding patient and ask the surgeons to implement "damage control surgery" if necessary "Routine" Labor and Delivery Learn from the care of the combat victim: ask the surgeons to consider damage control surgery for the bleeding patient Transfusion: Know what screening tests are performed on volunteer donor blood Transfusion of packed red blood cells requires a careful riskbenefit analysis MEDICATIONS Perioperative issues: INTRAOPERATIVE AND PERIOPERATIVE Basics: REGIONAL ANESTHESIA PACU PEDIATRIC ANESTHESIA NEUROANESTHESIA CARDIAC ANESTHESIA OB ANESTHESIA PAIN MEDICINE HUMAN FACTORS LEGAL PROFESSIONAL PRACTICE CODING AND PAYMENT-MAKE SURE YOU GET PAIDCOMMENCEMENT Index