How Breast Surgery Killed A Florida Teen

[NRSKarenRN]

interesting discussion. liked to hear our members thoughts.

[color=#5757a6]how breast surgery killed a florida teen

...what we know, so far, is that the 18-year old florida patient developed the very rare complication of general anesthesia, malignant hyperthermia, literally "dangerous [color=#006699]elevated temperature". .

...ga is the predominant choice of anesthesia cosmetic surgery, so her surgeon was within the ‘standard of practice' in that choice – expedience over outcomes.

unfortunately, ga or the ‘standard of practice' includes many unnecessary, avoidable and potentially fatal risks to patients choosing to have surgery that has no medical reason or indication.

among those avoidable risks are mh, blood clots to the lungs, airway mishaps leading to lack of oxygen to the patient's brain, postoperative nausea and vomiting (ponv), and postoperative cognitive disorder (pocd).

all of these risks can and should be avoided by having surgeons and patients choose a kinder, gentler anesthetic technique – propofol ketamine or minimally invasive anesthesia (mia)⮠pioneered by friedberg.

neither propofol nor ketamine are triggering agents for mh. had ms. kubela received mia, she would likely be alive today. bis monitoring of the patient's brain gives a numerical value of propofol sedation at which ketamine can be given without negative side effects...

teen dies after breast augmentation surgery - health news story ...

[paindoc]

Any anesthesia technician, whether they be CRNA or MD, should have recognized the issue and started immediate treatment. Anesthesiologists are not my "brethren"- I have never been a member of the A$A, and have little to do with the field of anesthesiology. Pain physicians are in a separate medical specialty from anesthesiology.

[stanman1968]

I am sorry but your original post singles out CRNA's and does not even consider one of your brethren being at fault. Your brethren being practitioners that do not know a CRNA's education or training but would presume to dictate our practice. And if you are not an anesthesiologist or a CRNA then I would have to say that you certainly are not in any position to criticize a field you are not trained in.

I am sure you would not appreciate me castigating you or your colleagues in the area of pain management, an area in which I am not well versed in i freely admit. Think about it.

[CerebralCRNA]

I have never been a member of the A$A, and have little to do with the field of anesthesiology.

Then how can you comment on areas like you have before with credibility if you are not experienced in the field??

[wtbcrna, MSN, DNP, CRNA]

If I remember correctly, Paindoc was an MDA that switched specialities and went into chronic pain management.

I think what he meant to say is that he doesn't have much to do with the field anesthesiology anymore.

[paindoc]

Correct, thank you! I was an anesthesiologist for many years and taught residents in an anesthesiology residency program, and was also in private practice. Doctors offices only uncommonly have MD anesthesiologists available for rendering anesthesia: typically they utilize CRNAs. The original report I read cited a "doctors office" which apparently was incorrect.

[stanman1968]

Aww shucks, you don't get out that easy, your statment origionally was about a CRNA only, not the I wonder who did the anesthesia, I wonder what steps,... just CRNA.

[paindoc]

The ability to read is a valuable commodity in the practice of anesthesia and in all walks of life. The ability to be truthful and accurate in restating what was read is equally valuable.

"Inhalational general anesthesia is not typically administered by a surgeon....usually in an office setting, this type of anesthetic involves a CRNA. Non-inhalational anesthetics usually do not trigger MH.

If there was a CRNA, what steps were performed to reduce the damage once recognized ? "

[airrn]

"Inhalational general anesthesia is not typically administered by a surgeon....usually in an office setting, this type of anesthetic involves a CRNA. Non-inhalational anesthetics usually do not trigger MH.

If there was a CRNA, what steps were performed to reduce the damage once recognized ? "

As Stanman pointed out where did you mention "if there was an MDA what steps were performed to reduce the damage once recognized."?

You, and the ASA have a very clear double standard. If an MD does something stupid it is OK because they were an MD and they get a slap on the wrist ex. Finklestein MD in New York or Tiwari MD in Indiana. Finklestein was "reeducated" for goodness sake. You mean to tell me after all his "superior" education he did not know any better? Fast forward to the also recent Las Vegas debacle the ASA comes out with a press release "stating American Society of Anesthesiologists (ASA) want to stress that contrary to many reports in the media, the "providers" administering the anesthesia with improper infection control techniques were NOT anesthesiologists (physicians with specialty training in the medical specialty of anesthesiology)." Even though this is a BLATENT LIE. To this date they still have NOT corrected the lie. There is NO EXCUSE for any of these practices whether an MDA or CRNA. Seems to me like there is plenty to clean up on your side of the house.

[paindoc]

Neither MDs nor CRNAs should have waited an hour before transferring the patient.

Now back to basics.....can you give me stats on the percentage of OFFICE ANESTHESIA provided by MDs? I happen to know of many examples of CRNAs delivering anesthesia in OFFICES of surgeons, but know of no MDs.

Accuracy in the ability to read is an important attribute of a CRNA.

[03snakecrna]

Please stick to your doc in the box business and stay away from real anesthesia providers! This is a horrible situation for all involved. MDA or CRNA it shouldnt matter WHO the provider was. This girl is dead! She paid the ultimate price and others will pay in emotional and financial damages. You are crazy if you give an anesthetic without dantrolene on site! I bet you re-use your epidural needles to!

Everyone, stop assaulting the CRNA profession. We are not going anywhere!

[deepz]

..........can you give me stats on the percentage of OFFICE ANESTHESIA provided by MDs? .......Accuracy in the ability to read is an important attribute of a CRNA.

Can you provide a quotation for that last assertion? Does that apply only to CRNAs? Or would that be an opinion applicable to all, perhaps, even to exalted MDs (major dieties)?

?

[foraneman]

Neither MDs nor CRNAs should have waited an hour before transferring the patient.

Now back to basics.....can you give me stats on the percentage of OFFICE ANESTHESIA provided by MDs? I happen to know of many examples of CRNAs delivering anesthesia in OFFICES of surgeons, but know of no MDs.

Accuracy in the ability to read is an important attribute of a CRNA.

We do not know if transportation was delayed for an hour alfter the diagnosis of MH was made. It seems very unlikely and we do not have the facts. What are the statistics regarding the percentage of OFFICE ANESTHESIA provided by CRNAs you have? Your personal anectdotes are not statistics. Personally I am aware of many examples of physicians delivering anesthesia in OFFICES of surgeons....in the state of florida. Accuracy in the ability to present unbiased critique is not an important attribute of an anesthesiologist.