another dental anesthesia death, how young is too young for these outpatient procedures?

[aneftp]

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Toddler's death after dental procedure in Greensboro sparks anesthesia safety concerns

The death of a two-year-old boy, Er'Mias Mitchell, after a dental procedure has raised questions about anesthesia safety protocols. With at least eight deaths reported over 13 years, there are growing calls for reform, including stronger requirements for anesthesia practices.

www.wral.com

I do not know the specific details. Obviously a pretty legit place to have dental procedures done with anesthesia. Complications can and will happen over time. Just the law of averages in our specialty.

1. What age is too young for stand a lone outpatient dental procedures with anesthesia. These are baby teeth anyways especially at 2 years old. I don't even know the physiological age of the 2 year old if they were born weeks early or not?

I was hesitant when my son had to have a dental procedure at age 4 and he was a big boy even at age 4. I decided to take him to the state owned university owned mega dental complex to have it done because it was "full service" facility with all the bells and whistles you can expect from a big place. But adverse events can happen anywhere outpatient or inpatient.

I'm sure everyone was experienced at that facility in North Carolina.

Some lawyer is gonna to get a massive payday out of this regardless.

 

[coffeebythelake]

Everythjng has risks. Even the most routine anesthetic with a separate anesthetic provider

 

[HalO'Thane]

I work full-time at a Children’s Hospital. 2 years old is probably about the youngest that we tend to do for dental procedures at our standalone surgery centers. This is assuming that the patient does not have any major comorbidities, such as OSA, congenital cardiac disease, lung disease, or syndromes that may potentially lead to a difficult airway.

At the places that I work, I feel better knowing that we have the full scope of difficult airway equipment, we usually have other colleagues around to back us up, and on most days an ENT surgeon is operating in the next OR if things were to ever get really dicey.

I obviously can’t speak on behalf of the dental surgery center where this patient died, but I do know that there are plenty of surgery centers that exist which lack all of the tools that are a part of the pediatric difficult airway algorithm and colleagues to back them up.

 

[deleted87051]

I work full-time at a Children’s Hospital. 2 years old is probably about the youngest that we tend to do for dental procedures at our standalone surgery centers. This is assuming that the patient does not have any major comorbidities, such as OSA, congenital cardiac disease, lung disease, or syndromes that may potentially lead to a difficult airway.

At the places that I work, I feel better knowing that we have the full scope of difficult airway equipment, we usually have other colleagues around to back us up, and on most days an ENT surgeon is operating in the next OR if things were to ever get really dicey.

I obviously can’t speak on behalf of the dental surgery center where this patient died, but I do know that there are plenty of surgery centers that exist which lack all of the tools that are a part of the pediatric difficult airway algorithm and colleagues to back them up.

Surgery centers will never be as safe as a hospital.

A few years ago, we had a case where a surgeon got into the iliac vein during a lap inguinal hernia repair leading to massive hemorrhage. The only reason that patient lived was because the surgery center was across a parking lot from the L1TC hospital. Hospital resources that were used to save the patient include:

1. Uncrossmatched O neg blood from the hospital blood bank. Thankfully there was a blood bank technician on duty that day who was willing to listen to reason and understood the gravity of the situation. She released the blood against policy.

2. Vascular/trauma surgeon from the hospital.

3. Vascular tray from the hospital.

4. Experienced scrub tech from the hospital.

4. 3 anesthesiologists and 2 anesthesia techs from the hospital.

5. Aline transducer and Aline kit from the hospital.

6. Transfusion pumpset and blood warmer from the hospital.


Bleeding was controlled at the surgery center and pt was transported by ambulance to the hospital ICU. He had a cleanup expl lap the following day and went home a couple days after that. Surgicenters are cheaper for a reason.

 

[IlDestriero]

Our Children’s Hosptial ASC age cut off is 6 months. We routinely take care of kids under a year at the ASCs. They are remote from the main hospital.

 

[AKMD_1984]

Surgery centers will never be as safe as a hospital.

A few years ago, we had a case where a surgeon got into the iliac vein during a lap inguinal hernia repair leading to massive hemorrhage. The only reason that patient lived was because the surgery center was across a parking lot from the L1TC hospital. Hospital resources that were used to save the patient include:

1. Uncrossmatched O neg blood from the hospital blood bank. Thankfully there was a blood bank technician on duty that day who was willing to listen to reason and understood the gravity of the situation. She released the blood against policy.

2. Vascular/trauma surgeon from the hospital.

3. Vascular tray from the hospital.

4. Experienced scrub tech from the hospital.

4. 3 anesthesiologists and 2 anesthesia techs from the hospital.

5. Aline transducer and Aline kit from the hospital.

6. Transfusion pumpset and blood warmer from the hospital.


Bleeding was controlled at the surgery center and pt was transported by ambulance to the hospital ICU. He had a cleanup expl lap the following day and went home a couple days after that. Surgicenters are cheaper for a reason.

this has happened to me by an incompetent surgeon in the hospital who put the trochar through the iliacs…

then had the balls to blame anesthesia for high blood pressure

i saw the whole thing on the screen as he was advancing the trochar

it was pretty damn amazing actually

immediately called my chief and we resuscitated the patient called him out on on it… the surgeon was quiet the whole time

had been caught red handed

 

[Teillard]

1. Uncrossmatched O neg blood from the hospital blood bank. Thankfully there was a blood bank technician on duty that day who was willing to listen to reason and understood the gravity of the situation. She released the blood against policy.

Well that's about as common as a virgin in the Navy...would have been fired at our BB regardless out outcome.