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The 911 call is available online. It’s disturbing.
The CRNA called. No urgency in his voice. Minimal detail. Said she had a “brief asystole” and didn’t wake up. It’s good that he can’t practice. There’s something wrong with him.

Link? I tried searching but couldn't find it
 

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Link? I tried searching but couldn't find it


You can find it in this article. Definitely disturbing.
 
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epidural man

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do you have any information to support that?

from the 6th ed. of Big Miller (vol. 2, Chap. 46, p.1794-5):

The Patient Undergoing Liposuction
...

Further complicating the management of liposuction patients are the large doses of lidocaine administered. During this procedure, patients receive up to 70 to 80 mg/kg of lidocaine. Vasoconstriction and removal of most of the infused solution is thought to prevent lidocaine toxicity.[141] However, one report suggested that lidocaine might impair alveolar epithelial fluid clearance. This impaired clearance of pulmonary fluid in conjunction with increased intravascular volume from the absorbed solution may explain some of the adverse occurrences, including death, reported after liposuction. There are significant data to support the increase in the maximum dose of lidocaine from the standard 7 mg/kg, but the maximum safe dosage of lidocaine for tumescent liposuction is still an area of controversy.

The American Academy of Dermatology has published guidelines for liposuction. The use of significant amounts of intravenous sedation or analgesic administration was considered to be potentially dangerous, particularly when conducted in an office-based setting. The recommended maximum dose of lidocaine was 55 mg/kg. This increased dosage mandates proper preoperative evaluation of patients' medications to determine whether they are using any drugs that inhibit the cytochrome 3A4 or 1A2 system. These are the major pathways by which lidocaine is metabolized, and even mild inhibition of these enzyme systems can lead to potentially lethal serum lidocaine levels.

Controlled trials regarding the best method for performing liposuction are lacking. However, a large body of practical knowledge suggests that liposuction can be performed safely using large doses of lidocaine and large volumes of infused solution. Vigilance regarding potential volume overload and pulmonary edema is required to safely perform this procedure.
 

epidural man

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The doses and manner of injections i described follow current guidelines practiced by specialty boards.....as I previously stated lidocaine was developed by a Swedish anesthiologist in the 1940's, it went on sale in the USA in 1948, the anesthesiologist who "discovered" it felt 1 gram was acceptable....
the FDA's recommendation in 1948 was based on epidural injection case reports....in the last 70 years there has been a plethora of information regarding blood serum levels, dilutions and injection sites.....this info is not my opinion (in fact i practice well below the guidelines), guidelines of specialty boards and surgical organizations recognize injections of up to 55mg/kg... you may want to reflect that this is not based on thousands of cases, but millions (over 250,000 liposuction cases are performed yearly just in the USA) .

The 55mg/kg comes from dermatology literature.

From my previous post reference 141

141. Dermatol Surg. 1996 Nov;22(11):921-7. Tumescent anesthesia with a lidocaine dose of 55 mg/kg is safe for liposuction. Ostad A, Kageyama N, Moy RL. Department of Dermatology, New York University School of Medicine, New York, USA.
 

epidural man

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Why do you all not think this death was LAST? Intercostal are basically giving it IV.

Regarding tumulscent lidocaine,

I quit working at a plastic surgeons office because of this issue. I just wasn’t comfortable with the levels.

I don’t care what Derm literature says because in the end, the FDA says - you better not use
More than 7mg/kg. I feel like that is pretty clear by a powerful regulating body.

One of my wonderful mentors, Red Howard, had this to say to me some years ago on the subject.

“ Despite all the published self-serving "safety studies" now in the dermatologic literature, I remain unpersuaded that patient safety is the underlying motive behind the increasing popularity of using mega-dose lidocaine in liposuction. This situation seems all too similar to the recent attempts by gastroenterologists when they ask that we allow nurses without adequate training in anesthesia to push propofol during colonoscopies. And when a "dermatologic surgeon" asks me to provide MAC while he administers tumescent local, I get a sense, albeit a bit different, akin to being asked to provide anesthesia for chiropractic manipulation -- it is something that has probably been done profitably thousands of times, but doing so just seems contrary to the high expectation I have of the anesthesiologist as the physician who protects the patient from those rare demons of injury that still lurk in the surgical theater. The simplistic horrors of pre-anesthetic surgery have been banished for over 150 years, so the the sophisticated anesthesiologist worth his seasoned salt now confronts rarer, subtler dangers as surgeons today push the few limits we have empirically, even if unscientifically, set for ourselves. “
 

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  • AM News 1999 - Lidocaine dose questioned in liposuction deaths.doc
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Nov 24, 2007
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How is Rex Meeker still allowed to practice as a nurse. It says a lot about the BON. Never about patient care.
I guess it’s common for nurses to leave their non critical patients for a significant amount of time, so he should be good.
If that was my kid, at some point they’d be searching for a body that would never be found. If you care so little for the lives of the people that you are caring for that you’d abandon them to have lunch while under anesthesia, don’t expect their loved ones to value your life.
 
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Jul 5, 2020
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Anecdotally, I have had orthopedic surgeons tell me they used to inject up to 300 mL of ropi 0.2% for decades without problems on their joints.
 
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Come on, I think everyone would sound that way if they had realized permanent damage has been done to a previously healthy 18 year old. I don't know what you want him to sound like hours after. I'm sure the panic phase had passed and the gravity of the situation was settling in.
 
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On drugs? Drunk? Maybe thats why he waited so long, to let it get out of his system. In case they tested his blood or urine.
They were deluding themselves thinking that there was no permanent damage and that she was young and healthy and would just wake up eventually. That would have been true if they were monitoring her closely and immediately treated her LAST or whatever, caused her initial hypoxia/PEA/asystole, but they were busy getting a sandwich and hitting the head while the block set up. I’m sure the alarms were all turned off as well, because they’re annoying to the surgeon. If I was responsible for something like that I’m not sure I could live with my guilt. The degree of negligence is so unbelievable they should be in jail.
 
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They were deluding themselves thinking that there was no permanent damage and that she was young and healthy and would just wake up eventually. That would have been true if they were monitoring her closely and immediately treated her LAST or whatever, caused her initial hypoxia/PEA/asystole, but they were busy getting a sandwich and hitting the head while the block set up. I’m sure the alarms were all turned off as well, because they’re annoying to the surgeon. If I was responsible for something like that I’m not sure I could live with my guilt. The degree of negligence is so unbelievable they should be in jail.
This is why I’m convinced something is/was wrong with this guy. This is so egregious I can’t even fathom a mentally normal, unimpaired person doing it.
 
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coffeebythelake

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Didn’t he do it twice?

Unclear what the circumstances were thr first time around. But yes, this is his second time having a healthy elective surgery patient die which should be eyebrow raising

Independent CRNAs. 4:1 ratio you wouldn't know what the hell he is doing. You assume there will be some basic competency and sense. But in a busy practice you might just be there to put out fires. I imagine something like this would never happen if he was supervised. But having said that I wouldn't ever want to supervise a guy like Rex Meeker. Would you?
 
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