Cardiac Arrest In The OR

My hospital routinely runs mock codes in a variety of settings to make sure that all providers can quickly and efficiently act as a team if the worst happens. This includes our operating rooms. Cardiac arrest under anesthesia in the OR is fortunately rare.  The total number of OR procedures performed in the US last year was 51.4 million. The incidence of intraoperative cardiac arrest has been quoted as less than 0.1%. However, a small percentage of a large number is still a fairly significant number. Getting prepared for rare events is often more challenging than preparing for regular events. When a rare event happens the shock and fear induced by the event can erase protocol from the most prepared mind. Let me share some of the things that I’ve learned over almost 36 years of OR emergencies. Continue reading

Protect Yourself From Infection In The Workplace

I don’t know if you have been following the MERS outbreak in the news but it does raise some concern. The CDC issued a MERS advisory yesterday. July 11, 2015 ABC news story covering CDC announcement of MERS outbreak status.

There are several animal and avian viruses that show the potential of becoming easily transmissible to humans. MERS, H7N9 and H5N1 are already spreading in humans, although not easily. The last major jump from animal to human occurred with the 1918 flu pandemic where an estimated 40 million people died. Mortality from MERS is currently 330-40% in the Middle East and 10% in South Korea. As health care workers, how we approach infectious disease precautions will have a lot to do with how safe we and our patients are in the workplace. Continue reading

Embrace the Catastrophist Within: Protecting Ourselves From Respiratory Infection

My husband calls me his catastrophist. I’ll admit it. I relish disaster movies and read history about plagues and calamities. All my knick-knacks are glued down in anticipation of the next earthquake. I’m always pointing out the worst possible thing that could happen when we embark on any adventure —even if that adventure is barbecuing in the backyard.

But a good anesthesiologist, or any health care provider, has to embrace the catastrophist within because our goal is to protect our patients from the unexpected. We have to constantly imagine the worst-case scenario so that if, or when, it happens we not only recognize it early, we’re ready for it. What we’re often not good at is protecting ourselves at work. We tend to be so patient focused that we often don’t even think about personal hazards. Continue reading