Ethical Issues

Question 1

What is a but for or cause-in-fact

Answer 1

injury would not have occured but for the provider actions. proximal cause is established

Question 2

substantial factor

Answer 2

providers acts are still a substantial factor despite other cause, proximal cause is established

Question 3

two most common instances of res ispa loquitur

Answer 3

spone or clamp left in patietn

2nd most common is positioning injury

Question 4

slander

Answer 4

verbal

Question 5

libel

Answer 5

written

Question 6

4 things for malpractice

Answer 6

duty
breach of duty
causation
damages

Question 7

how long is the statue of limitations

Answer 7

3 years., but this starts at 18years old

Question 8

poor handoff can lead to charge for

Answer 8

patient abandonment

Question 9

punitive damags

Answer 9

rare punishment for rechless or malicous behaviour

Question 10

schedule 1 drugs

Answer 10

no known medical use

Question 11

schedule 2 drugs

Answer 11

high potential for abuse

barbiturates
cocaine
meth
methadone
hydromorphone
meperidien
fentanyl
morphine
oxycodoe
hydrocodone

Question 12

schedule 3 drugs

Answer 12

ketamine
tylenol with codeine
bpurenorphine
steroids?

Question 13

class 4 drugs

Answer 13

benzos
phenobarbitol

Question 14

class 5 drugs

Answer 14

lyrica
robatusin

Question 15

what can happen after discovery

Answer 15

insurance may settle even if you did nothing wrong

Question 16

when do cases go to trial?

Answer 16

usually only if defense case is exceptionally strong

Question 17

most common anesthesia related law suits

Answer 17

1. death
2. nerve damage
3. permament brain damage
4. awareness

Question 18

top causes of death and permanent brain damage from anesthesia

Answer 18

1. inadequet ventilation
2. un recognized esophageal intubation
3. difficult intubation

Question 19

most commonly injured nerve

Answer 19

ulnar nerve from block or positioning

Question 20

main thing we do in anesthesia

Answer 20

identify, anticipate, and manage risk

Question 21

OB makes up what percentage of claims

Answer 21

9%

Question 22

in what area of anesthesia are there increasing claims?

Answer 22

chronic pain

Question 23

what do emancipated minors get?

Answer 23

the rights of adults

Question 24

what to know about blood in JW minor

Answer 24

tell family a court order will be pursued if an emergency requinig blood occurs.

if the likelhood of bleeding is high obtain court order before surgery

in life threatening emergency, transfusion should be given before the court order has been obtained

Question 25

waht does assent mean

Answer 25

older kids can "consnet" for their own care if they are capable.

Question 26

what is a mature minor

Answer 26

at least 14, can give informed consent if granted by the court but typically only make low risk decisions

Question 27

what about pregnant minor and abortion

Answer 27

may need parental consent ot have an abortion

Question 28

par en patriae

Answer 28

government basically protects those unable to protect themselves

Question 29

what makes an emancipated minor

Answer 29

married pregnant or has kids in the military economically independent

Question 30

should you report an error if it does not cause patient harm?

Answer 30

AMA guidelines say not necessary, but a strong ethical argument supports informing the patient of mistakes even if no harm is done. this is why it is importnat to disclose risks initially, so they can be told when they become a reality

Question 31

how many anesthesia errors are human errors?

Answer 31

70%

Question 32

24hrs awake is BAC of what

Answer 32

0.1%

Question 33

annual and lifetime radiation expsoure limits

Answer 33

5Rem / year 100Rem for a lifetime

Question 34

noise should be less than whath for 8hrs

Answer 34

90dB

Question 35

single noise less than?

Answer 35

115dB

Question 36

auditory alarms how much louder than OR?

Answer 36

20dB above the OR noise

Question 37

symtpoms of MRI exposure

Answer 37

transient N/V, dizziness, vertigo, light flashes

Question 38

SUD disorder affects how many anesthesia providers

Answer 38

10-15%

Question 39

SUD require how long in recovering and monitoring for how long?

Answer 39

1 year in recovery and 5 year monitoringwith random drug screens

Question 40

what is the triple aim

Answer 40

improve pt experience improve population health reduce per capita cost

Question 41

national instutite of medicine 6 domains

Answer 41

pt centered safe effective timely efficient equitable

Question 42

most chronic pain claims are from what? with how many resulting in permanent spine injury?

Answer 42

cervical spine injectison with >50% resulting in permanent spine injury.

Question 43

how many providers relapse after SUD issue?

Answer 43

40%