RESUMEN
Obstetric hemorrhage can bring significant challenges to the obstetrician and anesthestiologist. Optimal management requires a systems-based multidisciplinary and intraprofessinal approach, and implementation leadership is now the cornerstone of successful hemorrhage management. The National Partnership for Maternal Safety recently released a patient safety bundle for maternal hemorrhage. The bundle lists 13 resources that should be implemented in every delivery unit in the country to optimize readiness, recognition, response, and reporting and systems learning for obstetric hemorrhage. Anesthesiologists are expert in resuscitation and systems-based response, and can help lead both bundle implementation and clinical teams responding to obstetric hemorrhage.
Asunto(s)
Anestesiólogos , Grupo de Atención al Paciente , Seguridad del Paciente , Hemorragia Posparto/terapia , Protocolos Clínicos , Conducta Cooperativa , Parto Obstétrico , Femenino , Humanos , Evaluación de Procesos y Resultados en Atención de Salud , Hemorragia Posparto/diagnóstico , Hemorragia Posparto/prevención & control , EmbarazoRESUMEN
We present the case of an accidental extubation in a prone-positioned patient with a challenging airway because of Klippel-Feil syndrome and previous cervical spine fusions. The surgical procedure was well underway when this occurred, which added substantially to the difficulties produced by this event. We herein highlight the corrective steps we took in our case. We also recommend the need for a comprehensive preoperative briefing with all operating room personnel together with an action plan for how to prevent this particular scenario.
Asunto(s)
Extubación Traqueal/efectos adversos , Complicaciones Intraoperatorias/diagnóstico , Intubación Intratraqueal/efectos adversos , Síndrome de Klippel-Feil/cirugía , Posicionamiento del Paciente/efectos adversos , Posición Prona , Adulto , Anestesia General/efectos adversos , Femenino , Humanos , Complicaciones Intraoperatorias/etiología , Síndrome de Klippel-Feil/diagnósticoRESUMEN
Harlequin ichthyosis (HI) is a rare disorder of defective lipid transport resulting in severe epidermal hyperkeratosis producing large plate-like scales. Although mortality is high, improved treatments have allowed some with HI to survive into their third and fourth decades. However, until this case, there have been no known reports of pregnancy followed by birth of a healthy neonate to a mother with HI. We report one of the only approximately 25 known current HI survivors worldwide unique in having carried a pregnancy to full term and outline challenges for the anesthesiologist during labor and delivery.
