CRNA and patient death

ahs2015 · Oct 2, 2015

Following as I am interested in this as well

heatherisbetter, BSN · Oct 2, 2015

Or if there are previous topics on this I would love a link :) THANKS AN

allnurses Guide · Oct 3, 2015

Anesthesia related deaths occur 1:300,000 anesthetic cases, and most of those will be high risk/sick patients to begin with.

I have only had one patient in 7+ years of doing anesthesia that died shortly after her surgery. She was elderly and very sick to begin with.

It is sad and you will always question yourself when something happens to your patients, but ultimately everyone dies even despite often valiant effort of healthcare providers.

ahs2015 · Oct 3, 2015

How common are other anesthesia related injuries that do not result in death? For example, I'm wondering if it's somewhat common to have a patient experience paralysis from an epidural. That's just one example.

allnurses Guide · Oct 3, 2015

Serious complications from anesthesia are rare. The most common complication is corneal abrasions.

Permanent paralysis from an epidural I guess would be around 1 in a million. I don't know if there is an accurate statistic on that. Epidural hematoma after epidurals are somewhere around 1 in 200,000, usually only occur in higher risk patients (patients with prolonged bleeding/low platelets etc.).

Patients are much more likely to have a surgical complication that anesthesia has to account for and manage than a major anesthetic complication.

BigPappaCRNA · Oct 4, 2015

Patients for elective procedures just really don't die very often. In 23 years of clinical practice, the ONLY deaths that I have ever seen are acute trauma cases, and nobody beats themselves up over those. Outside of the movies, Intra-op deaths are very, very rare.

As far as getting paralyzed from an epidural, everyone always has a friend, of a friend, of a friend, who was paralyzed. We are usually told this as we are placing their labor epidural. Upon asking a few questions, it always turns out not to be the case. Epidural abscess is about the only real potential for any type of significant and meaningful paralysis, and those are exceedingly rare. When done correctly, anesthesia is extremely boring and drama free.

jwk · Oct 4, 2015

Like the others indicated - death from anesthesia is extremely rare. Perioperative death due to the patient's presenting condition are much more likely, though also uncommon. Trauma, ruptured aneurysm, fulminant sepsis, and perhaps PE would be among the things we would see most often. Loss of airway, one of the things feared most often in anesthesia, is much less probable than it was even five years ago with the widespread use of video-laryngoscopes. The OP' statement - "I know that a lot of the times the death will fall back on the anesthesia team"- is not reality.

amber0627 · Oct 5, 2015

I was curious about this as well, so more often death or other complications are from the procedure itself or an illness they already have?

heatherisbetter, BSN · Oct 5, 2015

Like the others indicated - death from anesthesia is extremely rare. Perioperative death due to the patient's presenting condition are much more likely, though also uncommon. Trauma, ruptured aneurysm, fulminant sepsis, and perhaps PE would be among the things we would see most often. Loss of airway, one of the things feared most often in anesthesia, is much less probable than it was even five years ago with the widespread use of video-laryngoscopes. The OP' statement - "I know that a lot of the times the death will fall back on the anesthesia team"- is not reality.

Lol shows how much I know.. I was just aware that CRNAs were required to hold very expensive insurance to avoid a lawsuit over patient death but if its as rare as you all make it seems, I have less to worry about which is GOOD :)

subee, MSN, CRNA · Oct 8, 2015

Heather is better:Expensive insurance doesn't protect you from lawsuits. If no one had insurance there would be a lot less lawsuits and lawyers willing to take consignment cases. After 35 years, I was sued once. It involved a patient death several days post-op and it was devasting. After a while you just realize it is the price of doing what you do. My personal liability was so small that the payment reflected that it was a nuisance suit (and my employer forced a group of us in the department to settle - lawyer's bills eventually equaled the amount for which we were being sued). I was sued a again many years later for loss of a tooth and it was dropped because of good charting.

gazpaz · Oct 10, 2015

Most CRNAs that I know, myself included do not carry personal malpractice insurance. It is provided by the hospital or anesthesia group. Having deep pockets (carrying too much insurance) can be a bad thing.

I agree with all previous comments, most complications from anesthesia are extremely rare. Corneal abrasions were actually a big topic with us last year (we had 2 in one year). My only patient death was a massive trauma that wa bleeding out. Unfortunately there are somethings that cannot be fixed with surgery.