In practice, there are many medical disputes related to anesthesia, including preoperative evaluation of anesthesia, intraoperative anesthesia, and postoperative recovery process.
1. Common complications of anesthesia.
Anesthesia is divided into local anesthesia and general anesthesia, local anesthesia is easy to cause serious complications mainly neuraxial anesthesia and brachial plexus anesthesia, the former is easy to cause subarachnoid blockage, cauda equina syndrome, total spinal anesthesia, etc., the latter may cause pneumothorax, cause diaphragm anesthesia to lead to respiratory failure, damage to the throat nerve resulting in hoarseness or suffocation; General anesthesia has more complications, such as inducing lung infection, anaphylactic shock, respiratory failure, cardiac arrest, etc., which are more dangerous. Therefore, anesthesiologists should strictly abide by the diagnosis and treatment standards before, during and after anesthesia to avoid accidents.
2. Common Anesthesia complications that cause disputes and precautions for dispute handling.
Preanesthetic evaluation is inadequate.
The controversy caused by the lack of pre-anesthesia assessment is mainly due to the failure to carefully assess the potential risk of cardiovascular and cerebrovascular accidents before anesthesia, and the poor reserve of respiratory function, because anesthesia is easy to cause blood pressure fluctuations, especially intraoperative blood pressure drops, and at the same time, because anesthesia is easy to cause respiratory secretions to be difficult to excrete and respiratory depression, and there may be cardiovascular and cerebrovascular accidents or respiratory failure caused by severe lung infection during and after surgery. Carotid ultrasound, cardiac ultrasound, electrocardiogram, BNP and other examinations are very important, if the patient has a relevant medical history, the hospital does not improve the relevant examinations to evaluate the cardiopulmonary function and the above complications occur, the hospital needs to be liable.
The anesthesia accident rescue is not timely.
Although the diagnosis and treatment standards require anesthesiologists to monitor the whole process of surgery, there are not a few people who steal mobile phones and temporarily leave their posts, because it is very common for patients to have unstable vital signs during surgery due to anesthesia. Although intraoperative anesthesia accidents often lead to extremely serious damage consequences, it is quite difficult for the patient to protect his rights, because the operation and anesthesia are not carried out under the supervision of family members, and the anesthesiologist will never record the content that is unfavorable to him on the anesthesia record. In practice, if it can be copied to the operating room monitoring by some means, it will be of great help to the case handling.
Inadequate postoperative monitoring.
This is the type of anesthesia-related medical dispute that Mr. Lin has been in contact with the most, and the reason for the occurrence is often that the patient's recovery is incomplete or delayed, and the anesthesiologist is too lazy to wait for the patient to wake up before extubating, and at the same time ignores the condition, and the patient is transferred to the ward by ** or intern, resulting in the patient's respiratory and circulatory failure on the way and the serious consequences of not being rescued in time; Of course, there are also patients who are slow to wake up from anesthesia, and the hospital does not pay attention to it, and only when it is found that something is wrong to go for examination, do they consider cerebrovascular accident, especially ischemic stroke, which delays the first time window for revascularization. This type of case requires the patient to carefully collect evidence on the anesthesia records and post-anesthesia visit records, and the diagnosis and treatment standards require the patient to have normal vital signs and be conscious before extubation, and the anesthesiologist should pay attention to whether the patient has tracheal spasm and secretion blockage when extubating, and the patient needs to be accompanied by an anesthesiologist and ** after extubation, and there is ECG monitoring, oxygen inhalation facilities, and infusion channels to transfer together, which also requires the patient to copy the monitoring on the transfer process in time to fix the evidence of the hospital's non-standard transfer on the way.
3. Evidence collection should be swift and resolute.
As mentioned earlier, it is difficult to fix the evidence of anesthesia-related medical damage during and after surgery, which requires the active efforts of the patient's friends, the copy of monitoring ** is the most important part, if it can be copied or sealed, there is a chance of winning the rights protection, if the patient's friend fails to communicate with the hospital through his own copy**, then it is necessary to collect evidence through the public security organs, do not delay because of the difficulty of evidence collection, if the monitoring ** is deleted or covered, then the opportunity to collect evidence is lost, which is extremely unfavorable to the case processing. If you don't know how to collect evidence, be sure to consult an experienced medical lawyer.
In short, anesthesia-related medical disputes often have serious damage consequences, but unlike other medical disputes, the monitoring of the operating room and the monitoring of the transfer are more important.