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Click on the blue words above to enjoy the feast of learning.
"Every day anesthesiologists are overloaded with work, just like in a storm, pulling a kite string between life and death.
I keep reminding myself that no matter how tired I am, I must stay awake".
.
.
Maybe Some people have seen this drama, "Anesthesia Storm" is a true portrayal of today's anesthesiologists
.
Every Tuesday, we share "Judicial Judgments and Medical Reflections on Anesthesia Dispute Cases" one case per week, and everyone is welcome to discuss the seventh round in the group.
The dosage of combined spinal-epidural combined drugs will not be judged overdose.
China is a veritable power of spinal anesthesia
.
Since the 21st century, the proportion of general anesthesia in the vast majority of domestic tertiary hospitals has increased significantly
.
Not only technological progress, but also the helplessness of reality
.
The harsh medical environment forces hospitals to pursue safer anesthesia techniques, but despite this, the application of neuraxial anesthesia in obstetric surgery still has its unique advantages, and its status is unshakable so far
.
However, postpartum patients receiving neuraxial anesthesia may have complex neurological deficits.
The reasons are intricate and may include anesthesia factors or may be induced by labor itself.
However, in the actual work summary, it is easy to be attributed to anesthesia.
Because of this, especially when there are some defects in the anesthesia link, it is even more difficult for anesthesiologists to exonerate their guilt, and sometimes they become scapegoats for no reason
.
Basic case: After cesarean section with combined spinal-epidural anesthesia, the patient had limited mobility of both lower extremities, numbness, decreased pain in the perineum and buttocks, accompanied by urinary and defecation disturbances, and had no sensation when urinating and could not control
.
Referral to a superior hospital for right lower extremity muscle strength 3, left lower extremity muscle strength 4 Rehabilitation treatment litigation and judicial judgment Judicial appraisal - 100% participation in the hospital There are no accurate, detailed and complete records, and the records of anesthesia do not meet medical standards
.
2.
There is no indication of whether the bupivacaine is the original solution or diluted, and there is no injection site, which does not meet the anesthesia record specifications
.
Medical thinking To cure sometimes, To relieve often, To comfort always.
---------EL Trudeau Dr.
Dredeau 1.
The details of the anesthesia specification determine whether the anesthesia of the hospital is in line with the specification, in fact, there is not much objective evidence , mainly based on the performance of the patients after surgery
.
However, the hospital believed that the MRI of the lumbar spine on the 5th day after the operation did not show spinal cord lesions, only the protrusion of lumbar 4-5 was found
.
Therefore, postpartum neurological symptoms and signs cannot be completely excluded from lumbar disc herniation
.
In fact, there is no conclusive evidence for this point on both sides, and the focus of the debate is mainly on whether the anesthetic is reasonable and whether there is an overdose
.
Expert assistants believe that the anesthesiologist's medication in this case is reasonable and reasonable, in line with medication habits, and there is no overdose
.
But the court found that the anaesthesia records did not show that different drugs were injected at different times and at different sites
.
There are irregularities
.
2.
Consideration of the risks of spinal anesthesia Although compared with general anesthesia, spinal anesthesia significantly reduces the risk of maternal and infant complications and death during childbirth, but it cannot be ignored that spinal anesthesia can be accompanied by a series of complications
.
Many risk factors that are easy to induce complications of spinal anesthesia are placed in a secondary position, which lays a safety hazard for the medical safety of anesthesia itself.
Spinal anesthesia in obstetric surgery has also become a hardest hit area for medical litigation and compensation
.
The reasons for the nerve damage left by spinal anesthesia are complicated, and sometimes the cause cannot be found at all, but it is easy to be "unnecessary" attributable to the anesthesia
.
Six days after the operation in this patient, the lumbar puncture cerebrospinal fluid was pale yellow, and the number of red blood cells was high, which may be due to improper operation, such as direct needle injury, epidural hematoma, and epidural abscess caused by infection
.
This patient's long labor, large fetus, and pelvic conditions may lead to lumbosacral trunk injury, coupled with lumbar disc problems, and also increase the risk of neurological complications after spinal anesthesia
.
However, due to the lack of strong rebuttal reasons or basis for avoiding responsibility, this issue deserves deep consideration by the industry
.
3.
Perform spinal anesthesia with caution and careful consideration.
Strictly grasp the indications and contraindications.
Strictly follow the operating procedures and specifications.
For patients with lumbar disc herniation, diabetes, and electrical injury, fully inform the risk of postoperative complications and weigh the pros and cons
.
For mothers with central nervous system diseases such as multiple sclerosis of the spinal cord, meningitis, spinal deformity and trauma, spinal tuberculosis and tumors, shock, sepsis, skin infection near the puncture site, coagulation dysfunction, etc.
, the anesthesiologist has sufficient reasons to refuse.
Maternal anesthesia was performed
.
General anesthesia for cesarean section please link ~ Anesthesia management points for general anesthesia for cesarean section For anesthesiologists, every step from preoperative visit, signing of informed consent, anesthesia implementation to postoperative analgesia, and postoperative follow-up must be Carrying out diagnosis and treatment in strict accordance with medical routines, and at the same time continuously improving one's professional technical level and enriching practical experience in anesthesia are the technical guarantees to avoid medical risks or enhance tolerance
.
END grateful heart thank you
"Every day anesthesiologists are overloaded with work, just like in a storm, pulling a kite string between life and death.
I keep reminding myself that no matter how tired I am, I must stay awake".
.
.
Maybe Some people have seen this drama, "Anesthesia Storm" is a true portrayal of today's anesthesiologists
.
Every Tuesday, we share "Judicial Judgments and Medical Reflections on Anesthesia Dispute Cases" one case per week, and everyone is welcome to discuss the seventh round in the group.
The dosage of combined spinal-epidural combined drugs will not be judged overdose.
China is a veritable power of spinal anesthesia
.
Since the 21st century, the proportion of general anesthesia in the vast majority of domestic tertiary hospitals has increased significantly
.
Not only technological progress, but also the helplessness of reality
.
The harsh medical environment forces hospitals to pursue safer anesthesia techniques, but despite this, the application of neuraxial anesthesia in obstetric surgery still has its unique advantages, and its status is unshakable so far
.
However, postpartum patients receiving neuraxial anesthesia may have complex neurological deficits.
The reasons are intricate and may include anesthesia factors or may be induced by labor itself.
However, in the actual work summary, it is easy to be attributed to anesthesia.
Because of this, especially when there are some defects in the anesthesia link, it is even more difficult for anesthesiologists to exonerate their guilt, and sometimes they become scapegoats for no reason
.
Basic case: After cesarean section with combined spinal-epidural anesthesia, the patient had limited mobility of both lower extremities, numbness, decreased pain in the perineum and buttocks, accompanied by urinary and defecation disturbances, and had no sensation when urinating and could not control
.
Referral to a superior hospital for right lower extremity muscle strength 3, left lower extremity muscle strength 4 Rehabilitation treatment litigation and judicial judgment Judicial appraisal - 100% participation in the hospital There are no accurate, detailed and complete records, and the records of anesthesia do not meet medical standards
.
2.
There is no indication of whether the bupivacaine is the original solution or diluted, and there is no injection site, which does not meet the anesthesia record specifications
.
Medical thinking To cure sometimes, To relieve often, To comfort always.
---------EL Trudeau Dr.
Dredeau 1.
The details of the anesthesia specification determine whether the anesthesia of the hospital is in line with the specification, in fact, there is not much objective evidence , mainly based on the performance of the patients after surgery
.
However, the hospital believed that the MRI of the lumbar spine on the 5th day after the operation did not show spinal cord lesions, only the protrusion of lumbar 4-5 was found
.
Therefore, postpartum neurological symptoms and signs cannot be completely excluded from lumbar disc herniation
.
In fact, there is no conclusive evidence for this point on both sides, and the focus of the debate is mainly on whether the anesthetic is reasonable and whether there is an overdose
.
Expert assistants believe that the anesthesiologist's medication in this case is reasonable and reasonable, in line with medication habits, and there is no overdose
.
But the court found that the anaesthesia records did not show that different drugs were injected at different times and at different sites
.
There are irregularities
.
2.
Consideration of the risks of spinal anesthesia Although compared with general anesthesia, spinal anesthesia significantly reduces the risk of maternal and infant complications and death during childbirth, but it cannot be ignored that spinal anesthesia can be accompanied by a series of complications
.
Many risk factors that are easy to induce complications of spinal anesthesia are placed in a secondary position, which lays a safety hazard for the medical safety of anesthesia itself.
Spinal anesthesia in obstetric surgery has also become a hardest hit area for medical litigation and compensation
.
The reasons for the nerve damage left by spinal anesthesia are complicated, and sometimes the cause cannot be found at all, but it is easy to be "unnecessary" attributable to the anesthesia
.
Six days after the operation in this patient, the lumbar puncture cerebrospinal fluid was pale yellow, and the number of red blood cells was high, which may be due to improper operation, such as direct needle injury, epidural hematoma, and epidural abscess caused by infection
.
This patient's long labor, large fetus, and pelvic conditions may lead to lumbosacral trunk injury, coupled with lumbar disc problems, and also increase the risk of neurological complications after spinal anesthesia
.
However, due to the lack of strong rebuttal reasons or basis for avoiding responsibility, this issue deserves deep consideration by the industry
.
3.
Perform spinal anesthesia with caution and careful consideration.
Strictly grasp the indications and contraindications.
Strictly follow the operating procedures and specifications.
For patients with lumbar disc herniation, diabetes, and electrical injury, fully inform the risk of postoperative complications and weigh the pros and cons
.
For mothers with central nervous system diseases such as multiple sclerosis of the spinal cord, meningitis, spinal deformity and trauma, spinal tuberculosis and tumors, shock, sepsis, skin infection near the puncture site, coagulation dysfunction, etc.
, the anesthesiologist has sufficient reasons to refuse.
Maternal anesthesia was performed
.
General anesthesia for cesarean section please link ~ Anesthesia management points for general anesthesia for cesarean section For anesthesiologists, every step from preoperative visit, signing of informed consent, anesthesia implementation to postoperative analgesia, and postoperative follow-up must be Carrying out diagnosis and treatment in strict accordance with medical routines, and at the same time continuously improving one's professional technical level and enriching practical experience in anesthesia are the technical guarantees to avoid medical risks or enhance tolerance
.
END grateful heart thank you
