Issues in Anesthesia – Airway Management

When a person is placed under general anesthesia, they are completely unconscious and temporarily paralyzed. This means that in addition to the risk of a bad reaction to the powerful drugs used in this process, there is the added danger of the patient’s body being partially shut down during the procedure. Regular necessary functions, such as breathing, must be carefully monitored to assure that the person’s wellbeing protected. In fact, airway management is one of the main areas where anesthesia complications have the potential to leave a patient permanently injured or even dead.

In a mere four minutes without oxygen, a person’s brain can be irreparably damaged; leaving them what is commonly referred to as “brain dead.” In the next few minutes, the body can continue to shut down, resulting in cardiac arrest and death. Thus, it is clear that making sure a surgical patient’s oxygen supply is safely maintained should be one of an anesthesiologist’s primary concerns.

In many cases of general anesthesia, a device known as an endotracheal tube is inserted into the patient’s windpipe to assure that it remains open and functional. This procedure carries its own risks, though. If the tube slips into the patient’s esophagus instead of trachea (windpipe), it will not deliver oxygen to the lungs, and the person will quickly suffer the grave consequences discussed in the previous paragraph. Also, if intubation is attempted and failed multiple times, trauma to the airway can cause swelling or obstruction, and seal the lungs off from the air they need. If this happens, an emergency tracheotomy must be performed, in which a hole is cut in the airway, allowing air to bypass the obstruction.

Ventilators are used to assure the exchange of gas for carbon dioxide inside a person’s lungs is able to continue normally when they are under anesthesia. If the ventilator is misused or malfunctions, though, this exchange may not properly take place, resulting in hypoxia (lack of oxygen), or if an excess of pressure is created, development of a hole in the lung.

While they are scary, these threats are very real. General anesthesia is not a procedure to be taken lightly, and medical professionals have a responsibility to assure their patients’ safety while they are unconscious. In the event that a doctor’s negligent behavior leads to the injury or death of an anaesthetized patient, they may face medical malpractice lawsuits and be required to pay compensation to the victim.

For more information about medical malpractice and anesthesia issues, visit the website of Pennsylvania medical malpractice lawyers Lowenthal & Abrams, P.C.

Incorrect Dosages of Anesthesia

Anesthesia has been a blessing to modern medicine. The amount of pain and suffering anesthesia can avoid is immense. Until it’s invention, people suffered from surgeries with little pain medication. Considering having wisdom teeth pulled with only alcohol to help with the pain or a limb removed while still having feeling. However, with this gift comes certain responsibilities in it’s administration.

With such a powerful form of medicine, if it is used incorrectly it can create huge problems for a patient. Malpractice in anesthesia often includes an anesthesiologist giving an incorrect dosage to the patient. The results can range from a minor increase to sickness to death.

In the event that a person or loved one is a victim of an incorrect dosage, there may be compensation available from the medical professionals to provide some relief from medical bills, emotional distress, and long-term damages and treatment. Discussing your case with an attorney may be the first step to securing it.

Consequences

The unfortunate results of incorrect dosages include creating disabilities with brain injuries and emotional trauma from a sickness which will involve years of care. The cost of sustained illness can be very high, leaving an innocent individual with tough financial circumstances that they do not deserve.

Wrong dosages can be caused by doctor error in amounts of anesthesia given. Even the wrong timing in administration can be dangerous. In many cases, inaccurate or misprinted labels can cause these errors. Sometimes, even something as simple as poor handwriting can lead to serious medical problems. The fault of these errors can be laid on several medical professionals, and a medical malpractice lawsuit may be the best way to secure money needed to pay for medical bills and other significant expenses.

Awake And Paralyzed During Surgery

The Trauma of Awakening

Awareness under anesthesia ranks second only to death as a dreaded complication of surgery. It is reported to affect 40,00-140,000 patients per year in the US but there is reason to believe that many more have awakened during surgery. Because modern anesthesia consists of three agents – a light dose of painkiller, a paralyzing drug, and an amnesic agent that blocks memory of the experience – most patients do not remember awakening and so do not report it to their doctors. The paralyzing drug prevents any struggle or gesture as sign of distress so the surgeon, the anesthesiologist, and nurse cannot see that the patient is awake. Some experimental studies estimate the rate of awareness may be as high as 44%.

Not remembering does not diminish the pain, fear, and utter helplessness of awakening under the knife and being unable to let anyone know. Nor does it diminish the traumatic effect of that experience. Survivors who finally recall the awakening usually describe an experience in which their center of awareness coalesces outside their helpless body and they watch the scene from above. Their frozen state and accompanying depersonalization seems to go on and on without a clear point of resolution. The return to the body may happen in the recovery room or even later in the hospital room and, rarely, only after days, weeks, or years.

Posttraumatic Consequences

The experience of awakening in a panic during surgery and finding oneself unable to move or cry out creates a dramatic crescendo of survival instincts. The drug-induced paralysis thwarts any impulse to escape and deepens the instinctual freeze response. Awareness during surgery carries the exact conditions known to induce post-traumatic symptoms. The horrors of the experience become embedded in the nonverbal mind with a potential to intrude into consciousness whenever triggered. The suffering individual will not relate the emerging panic to unremembered and wordless experiences during a past surgical operation.

Over half of the patients that remember coming light under anesthesia develop the full syndrome of posttraumatic stress disorder (PTSD). Survivors with or without memory often become phobic about surgery and their avoidance of triggers may generalize to a fear of hospitals or doctors or of white coats. They may suffer attacks of frozen panic or depersonalization, sometimes with clouded states of altered consciousness. They may repeatedly hear the voices of operating room staff. Their conditions are often misdiagnosed as panic disorder, major depression, schizophrenia, or epilepsy.

Treatment of Surgical PTSD

Once the true cause is suspected the condition can be readily treated and cured with trauma therapy. Successful treatment does require processing of the entire traumatic experience so the therapy must be able to access that seemingly forgotten memory. The memory is there even though conscious verbal probes fail to reach it. It was not verbally coded when the person was under the dual effect of the anesthetics and the instinctual trauma response. Even though it was stored in fragments of nonverbal perception it can be processed into a narrative form that will be available to conscious thought.

Hypnosis is very effective in providing access to the traumatic memory fragments. Other approaches that use nonverbal communication can also be effective. These are the creative arts therapies such as art therapy, movement therapy, music therapy and psychodrama. In most applications the person constructs a verbal narrative of the trauma and comes to own it as a finished historical event.