Chapter 31: Risk + Risk Management Flashcards
Define risk.
Danger or hazard; probability of suffering harm or other untoward outcome
Define complication.
A problem that makes a disease or condition worse or more difficult to treat
A problem that makes a disease or condition worse or more difficult to treat
Complication
Danger or hazard; probability of suffering harm or other untoward outcome.
Risk
Define side effect.
Consequence of an agent other than expected
Consequence of an agent other than expected
Side effect
Define adverse event.
Harmful, usually unexpected
occurrence; deviation from normal course or progression in recovery, health, or well-being
Harmful, usually unexpected
occurrence; deviation from normal course or progression in recovery, health, or well-being
Adverse event
Define acute.
Occurring during performance of a procedure, administration of a drug, etc.
Define intermediate.
Occurring during the existence of a drug or device in a patient
Define long-term.
Occurring after elimination of a
drug or removal of a device from a patient
ASA, Committee on Professional Liability:
Chair?
Location?
How many insurance companies participate?
Time period?
How many cases per year?
How many claims in database?
Chair: Frederick Cheney, Jr., MD (1985) Location: University of Washington, Seattle 35 insurance companies participate Time period: 1985 - present Cases per year: 300 Claims in database: 7300
The goal of the American
Society of Anesthesiologists (ASA) Closed Claims Project is to:
identify major areas of loss in anesthesia, patterns of injury, and strategies for prevention.
3 parts of goal of ASA Closed Claims project:
1) ID major areas of loss in anesthesia
2) ID patterns of injury
3) ID strategies for prevention
Name five means for confirming success or failure of endotracheal intubation.
1) Chest rises and falls
2) Condensation appears and disappears
3) Compliance of bag (refills)
4) Capnography
5) Auscultation
Gold standard for confirming endotracheal intubation
Capnography: 3 repeating waveforms
How many adverse respiratory event claims end in death or brain damage?
85%
Of those adverse respiratory event claims that ended in death/brain damage, how many were due to esophageal intubation?
18%
Of those adverse respiratory event claims that ended in death/brain damage, how many were due to difficult airway?
17%
Of those adverse respiratory event claims that ended in death/brain damage, auscultation led to a misdiagnosis in what percentage of cases?
48%
Proportion of anesthesia-related morbidity/mortality that are related to airway?
35% (Largest proportion compared to other reasons)
Difficult airway, percentage occurrence in: Induction: Intraop: Extubation: Recovery:
Of those, percentage that resulted in brain damage/death?
Induction: 67%, 48% in BD/D
Intraop: 15%, 69% in BD/D
Extubation: 12%, 92% in BD/D
Recovery: 5%, 58% in BD/D
Of those difficult airway events, an event in which stage of care is most likely to result in brain damage or death?
Extubation/emergence
Airway injury during procedure is more likely to be reported in which gender?
Female (69%)
