Anesthesia for HALO placement.

[GmanRN]

Had a patient the other day that required a HALO application related to a C2 nondisplaced fracture. The patient was a 16 yr old female. The Neuro Surgeon rounded with his nurse and she was responsible for the conscious sedation. Some dose of morphine and versed was used along with the local injection of Lido with epi.

The patient screamed and writhed in agony. Her heart rate reached 135 and she reported that she remembered the entire procedure. She described the feeling of the pins penetrating her skull.

Is it just me or does this just not sound right to you. I wrote it up.

What are your thoughts?

[GmanRN]

This is turning into a wonderful discussion.

I now understand that oversedation could have huge consequences in the application of someone with a cervical fracture. It would be dangerous due to possible chord damage if the need for intubation should occur.

I would think that a Ramsey score of 1 would reveal that this particular patient would have been considered lightly sedated. Maybe some room for at least a little more intervention from a skilled provider like one of yourselves. Too bad none of you were in the room. She could have benefited from an expert perspective.