Surgical Errors – Patient and Doctor Induced Emergencies

by Brian Warriner, MD

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    00:00 Like anesthesiologists, surgeons also make errors. One of the commonest errors is operating on the wrong side. So the wrong arm, or the wrong leg, the wrong eye. Any two sided organs can be operated on inappropriately. Procedures are in place in most operating rooms that require the surgeon to see the patient before entry to the operating room, and to mark the area to be operated upon with a marking pen. Despite this precaution, wrong sided surgery persists. And in my own hospital we had a case, about 3 or 4 months ago, with a surgeon who is very meticulous and very conscientious about marking and getting the right side. He did all that when the patient was lying supine in the holding area prior to going into the operating room. When the patient went into the operating room, she was turned prone for the surgery and he misidentified the side. And operated on the wrong foot.

    00:59 Fortunately, she needed the operation on that foot anyway, and they had planned to do the one foot first and then to do this other foot later. So they just ended up reversing the surgical order.

    01:11 But it was very, very fortunate that, that in fact was the case. Surgeons can also occasionally damage tissues in error during surgery. So, large blood vessels may be opened with resulting hemorrhage, or gut may be perforated, with resulting peritonitis, infection in the abdominal cavity.

    01:29 These are rare occurrences, but they persist. And are a constant concern of surgeons and health care organizations in general. So in summary, in this lecture we've talked about a number of emergencies that can occur in the operating room.

    01:47 This is by no means a complete list I hate to tell you. There are many other things that can go wrong. But these are things that have a direct bearing on Anesthesia or Surgery and some of them, such as Massive Hemorrhage, are relatively common. We ended up by talking about Medical Error, Iatrogenic disease. These things are of a very great importance to all health care providers and we're working very hard to reduce them. But unfortunately, as of the moment, we have not completely eliminated error in our operating rooms.

    About the Lecture

    The lecture Surgical Errors – Patient and Doctor Induced Emergencies by Brian Warriner, MD is from the course Emergencies.

    Included Quiz Questions

    1. Mark the area to be operated on with a marking pen.
    2. Confirm that the number of instruments, needles, and surgical gauzes is correct.
    3. Administer antibiotic prophylaxis within 60 minutes before the procedure.
    4. Confirm the patient's identity before the induction of anesthesia.
    5. Checking the patient's ABO blood type prior to surgery.

    Author of lecture Surgical Errors – Patient and Doctor Induced Emergencies

     Brian Warriner, MD

    Brian Warriner, MD

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