When things go wrong

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OP was asking for info When things go wrong... missed your expert response to the question asked

As an expert in anesthesia, I will offer a few answers. First, it depends on what goes wrong and who has control of the situation. There are times when there is massive hemorrhage at the surgical site. The surgeons try to control it surgically, the CRNA pumps in blood and fluid, monitors vital signs and makes necessary adjustments in the anesthetic agents to help stabilize the patient. Then there could be a fire in a surgical site that was prepped with alcohol and the cautery used. All of the members of the team would put out the fire, maintain oxygenation of the patient, make a decision about to proceed with the surgery. Then there is fetal distress and the need for a stat c-section where everyone in the team has a role to save the baby and the mother.

All of this points to the incredible team that is present in every operating room. We all have our role and the patient depends on us to know what we are doing and then do it.

What we do as CRNAs is make second to second decisions, that include a very quick assessment of the situation and being able to multitask and to keep focused and calm. That is why (1) you have to be very bright to qualify for anesthesia school--good grades, lots of critical care experience, (2) we get paid well and (3) anesthesia is not for everyone.

A recent example, last week I had a leak in my anesthesia system and while I could ventilate the patient, there was clearly something wrong. within 30 seconds I had to make a quick check of the anesthesia machine, connections, gases, ventilator, and tubings. When they were all normal, I checked the nasal endotracheal tube and determined the leak was there. I had to extubate the patient and reintubate without a muscle relaxant while trying not to contaminate the surgical field. Leak solved, patient did fine and all went well. It doesn't sound like a big deal...but I had to be an biomed engineer, a respiratory physiologist, make quick observations, identify and solve the problem.

I hope these examples helped answer your questions.

AE

Yeah, the CRNA gave me 3 of Versed prior to my ankle surgery, and I definitely remember it. I know that's not a large dose by any means, but I remember getting my nerve block like it was yesterday. That being said, once I got my propofol, it was all over

I wouldnt classify a pt "moving" on incision a complication---have to agree here staff, people posting here should have more knowledge about the subject, but I guess that is where others have to speak up---

ONLY 2 out of 8 is not ONLY. It is an extraordinarily high complication rate. And the previous post is correct. Movement on incision is not a complication. Trying to get of the table is poor anesthesia by a questionable provider.....unless these are the first and last times it ever happens in his room.

Serious unexpected complications are rare, but they by definition can become very labor intensive for a CRNA. Anesthesia is responsible for the medical care of the patient while in the OR and the medical treatment of all complications. Obviously the surgical treatment of complications is the responsibility of a surgeon.

The plural of anecdote does not equal data.


Now THAT is funny. I am soo going to use that on a student.