A patient committed suicide after being awake during his surgery:
The Baptist minister from Raleigh County, W.Va., killed himself in February 2006 ““- two weeks after he allegedly suffered the trauma of having surgery without anesthesia. The phenomenon of anesthesia awareness is associated with psychological conditions such as post-traumatic stress disorder.In a suit filed last month, Sizemore’s family say anestheliogist Dr. Bruce Cannon and nurse assistant Larry Rupe administered drugs to paralyze him, but failed to give him those that would render him unconscious and unable to experience pain. They did not realize their mistake until 16 minutes after the first incision.
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{ 8 comments }
It’s not a nurse assistant. It’s a Certified Registered Nurse Anesthetist. CRNAs are not assistants to physicians. Anesthesiologist Assistants are a different provider than CRNAs. Have a great day!
I thought it was pretty clear from the context that the word was being used in the colloquial sense: the CRNA was assisting the anesthesiologist.
Regarding the article… that’s just horrible. I can’t even fathom experiencing that. They say that they administered a drug to induce amnesia, which is probably midazolam, but this inhibits the formation of new memories… it doesn’t usually cause one to forget memories once they’re created. *cringe*
“They did not realize their mistake until 16 minutes after the first incision.”
Usually the anesthesiologist in a case like this is supervising multiple CRNA’s, maybe 3 to 4. The anesthesiologist is typically present on the induction of anesthesia; that is the administration of the paralysis medication and intubation, then leaves the room and periodically checks on the CRNA monitering the patient and responds to any problems. Hypertension and/or tachycardia might be the only manifestations of a problem in a paralyzed patient. It would be interesting to know the facts, but it is entirely possible that the anesthesiologist checked-in on the supervising CRNA 16 minutes after induction and noticed the anesthetic gas was not turned on or was not properly being delivered to the patient. It seems unlikely that two people would “miss” this.
I am a practicing anesthesiologist; no CRNA’s where I practice, but I’ve “supervised” before, It’s not a bad practice style either. These sort of incidents are unusual but not uncommon; I’ve heard of a one in onethousand incidience being cited, but I think it’s much more rare. Usually, patients aren’t fully conscious, but have some significant analgesia from narcotics and partial dose inhalation anesthesia. BIS monitors help (processed EEG) and Desflurane vaporizers, which have a low level alarm if the agent has run out (a common cause of awareness in my experience) Manufacturers should be required to put low level alarms o their vaporizers. Nice blog, by the way///
Lets get it right. I relieved on the case at least one hour later. Just check the record
Once again the poor patient is traumatized by getting anesthesia from an assistant or a nurse (crna) not an anesthesiologist. Nurses (and crna’s are nurses, not anesthesiologists by any stretch) have their place, but they should NOT administer anesthesia unless supervised. Any they clearly are not. When doctors get anesthesia, they get an anesthesiologist. The rest of us probably get a nurse (crna). Why not just let the secretary administer the anesthesia? With additional “training” anyone can do it, right? Even a nurse is better than an “assistant”; clearly they aren’t even credentialed to do anything, but they practice. When did the USA sink to this point? Even if you get an anesthesiologist; ask them if they are a US citizen. No? Why not. Do we really need the majority of anesthesiologists to come from India or another country? I guess that if they can run the majority of the 7-Eleven stores, then doing the majority of anesthesia cases is o.k. also. I’m an airline pilot and my business is simple, but we have safeguards to make it hard to screw up (if you follow procedures). Vaporizers should NEVER run low; make a checklist and set a timer if they don’t have adequate alarms.. Stop winging it: make a checklist, follow it and double-check everything. Stop relying on amnesia drugs to cover your sloppiness. Procedural amensia is often only temporary…then the fun starts whe the poor patient gets home..or don’t you care about this? Anesthesia often compares it’s “safety” recort to the airline industry; I’m sick of this. If I did my job like most anesthesia seems to be practiced, there would be alot of crashes.
I am so glad that when I need surgery, I have the means to go to a facility where anesthesia will be provided by a doctor, not a nurse. I was just told that I probably need GI surgery for cancer, but I will skip it before I consent to anesthesia from a CRNA (nurse). This concept is so deceptive and dangerous that I can’t believe that Americans buy into this! And you people want Obamacare? What’s next, allowing the unit clerk perform surgery?
I experienced awareness during gen anesthesia because a sevo vaporizer ran dry. I felt everything and it was terrible for about 15 min until someone realized “hey, this guy is sweating, vitals are all over the place and obviously in disstress. Then the “oh shit, the sevo is dry!. Anyway, errors happen. The inexcuseable part is that the anesthesia team tried to convince me that I imagined it all; until I told them everything that happened and I got a copy of the intraoperative report documenting the error. Lying about a patient experienceing awareness? Docs, are you proud of this? Wonder why I will never have surgery ever again? Errors happen, but decent docs don’t lie about it.
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