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  • Image not available. The rate of anesthetic complications will never be zero. All anesthesia practitioners, irrespective of their experience, abilities, diligence, and best intentions, will participate in anesthetics that are associated with patient injury.
  • Image not available. Malpractice occurs when four requirements have been met: (1) the practitioner must have a duty to the patient; (2) there must have been a breach of duty (deviation from the standard of care); (3) the patient (plaintiff) must have suffered an injury; and (4) the proximate cause of the injury must have been the practitioner’s deviation from the standard of care.
  • Image not available. Anesthetic mishaps can be categorized as preventable or unpreventable. Of the preventable incidents, most involve human error, as opposed to equipment malfunctions.
  • Image not available. The relative decrease in death attributed to respiratory rather than cardiovascular damaging events has been attributed to the increased use of pulse oximetry and capnometry.
  • Image not available. Many anesthetic fatalities occur only after a series of coincidental circumstances, misjudgments, and technical errors coincide (mishap chain).
  • Image not available. Despite differing mechanisms, anaphylactic and anaphylactoid reactions are typically clinically indistinguishable and equally life-threatening.
  • Image not available. True anaphylaxis due to anesthetic agents is rare; anaphylactoid reactions are much more common. Muscle relaxants are the most common cause of anaphylaxis during anesthesia.
  • Image not available. Patients with spina bifida, spinal cord injury, and congenital abnormalities of the genitourinary tract have a very increased incidence of latex allergy. The incidence of latex anaphylaxis in children is estimated to be 1 in 10,000.
  • Image not available. Although there is no clear evidence that exposure to trace amounts of anesthetic agents presents a health hazard to operating room personnel, the United States Occupational Health and Safety Administration continues to set maximum acceptable trace concentrations of less than 25 ppm for nitrous oxide and 0.5 ppm for halogenated anesthetics (2 ppm if the halogenated agent is used alone).
  • Image not available. Hollow (hypodermic) needles pose a greater risk than do solid (surgical) needles because of the potentially larger inoculum. The use of gloves, needleless systems, or protected needle devices may decrease the incidence of some (but not all) types of injury.
  • Image not available. Anesthesiology is a high-risk medical specialty for substance abuse.
  • Image not available. The three most important methods of minimizing radiation doses are limiting total exposure time during procedures, using proper barriers, and maximizing one’s distance from the source of radiation.

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Image not available. The rate of anesthetic complications will never be zero. All anesthesia practitioners, irrespective of their experience, abilities, diligence, and best intentions, will participate in anesthetics that are associated with patient injury. Moreover, unexpected adverse perioperative outcomes can lead to litigation, even if those outcomes did not directly arise from anesthetic mismanagement. This chapter reviews management approaches to complications secondary to anesthesia and discusses medical malpractice and legal issues from an American (USA) perspective. Readers based in other countries may not find this section to be as relevant to their practices.

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All anesthesia practitioners will have patients with adverse outcomes, and in the USA most anesthesiologists will at some point in their career be involved to one degree or another in malpractice litigation. ...

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