Is it unusual?
- Thread starter W222
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That totally depends on the acuity of your case load. If you're routinely involved in cardiac or trauma or transplants, you would probably be lucky to endure 10 years of practice without an intraop mortality.
If you work at a nice little community hospital or outpatient center, you could probably survive a career without a death.
Having said that, I went to a residency program with almost no trauma, and my one intraop mortality was peds cardiac. That's not considering the dozen or so that I took to the OR which I knew would be dead within 24 hrs in the unit.
If you work at a nice little community hospital or outpatient center, you could probably survive a career without a death.
Having said that, I went to a residency program with almost no trauma, and my one intraop mortality was peds cardiac. That's not considering the dozen or so that I took to the OR which I knew would be dead within 24 hrs in the unit.
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Never had one in the OR, but plenty of the above.
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I have had about a dozen of these, but I have been lucky to get everyone out of the OR. I have done alot of heavy stuff, guess its just a matter of chance. Some I know have had multiple in a week though.
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On my second call night but the guy was fileted open from an ED thoracotomy and his lung was flapping off the side of the gurney with each ambu breath with a thumb side gsw wound through it. Bullet also got his RV and PA we would soon learn. Bled out. So I dont really count that one as he was a goner.
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I've had two
One during residency, during an elective trach of all things.
Second was more recently. MAC case, went fine, threw a huge PE as we were transferring her to the gurney to get out of the OR, DRT. Not anybody's fault, but she still died in the OR.
One during residency, during an elective trach of all things.
Second was more recently. MAC case, went fine, threw a huge PE as we were transferring her to the gurney to get out of the OR, DRT. Not anybody's fault, but she still died in the OR.
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None in PP, but my wife has had a PA rupture that dissected distally... surgeon couldn't clamp and we didn't have enough time to start CPB as it happened fast and in the lateral position... chest filled up and couldn't keep up with the hemorrhage. Funny enough... she never had anyone die in residency despite a regional trauma center with plenty of cardiac, transplants and ASA IV and V's.
Despite not having lost anyone in PP, during residency I had my fare share. Ruptured AAA, MVC with multiple devastating injuries... led to a crani... opened up the cranial vault and brain literally popped out and continued to swell... surgeon had to shave off dead brain tissue in an attempt to get the skin to partially close after the skull was removed... ended up going into DIC and arrested towards the end of the case. Couple of toddlers/kids that came into the trauma bay with carbon monoxide poisoning from a apartment complex fire.... another guy who was having a massive transmural infarct on top of a critically low EF that came to the OR septic, severely acidotic and with free air... died shortly after induction. Cardiac transplant dude that ended up with a bleed as well as rejecting his new heart... died in the OR. Trauma MVC came in... went into asystole for some reason I don't remember... I do remember the trauma surgeon cracking open the chest and doing open cardiac massage...
These are the ones I remember off the top of my head. I'm sure there is more.
Although my residency pushed me hard, and I had many long and hard nights... the training was unbelievable. I'd get home sometime around 7:30 am, look back at some of the nights and think to myself.... Wow... you can't get any more real than that. I'm thankful of the experience as I usually run at 55bpm in the OR despite what might be going on.
Well... so far today, 1 fasciotomy 2/2 compartment, 2 hemi's, 2TFN's, now got an ORIF of a radial fx.... OB has been quiet...this is unsusual... but I'lll still get some sleep. That is one BIG differnce btw PP and the 'ol big house.
Despite not having lost anyone in PP, during residency I had my fare share. Ruptured AAA, MVC with multiple devastating injuries... led to a crani... opened up the cranial vault and brain literally popped out and continued to swell... surgeon had to shave off dead brain tissue in an attempt to get the skin to partially close after the skull was removed... ended up going into DIC and arrested towards the end of the case. Couple of toddlers/kids that came into the trauma bay with carbon monoxide poisoning from a apartment complex fire.... another guy who was having a massive transmural infarct on top of a critically low EF that came to the OR septic, severely acidotic and with free air... died shortly after induction. Cardiac transplant dude that ended up with a bleed as well as rejecting his new heart... died in the OR. Trauma MVC came in... went into asystole for some reason I don't remember... I do remember the trauma surgeon cracking open the chest and doing open cardiac massage...
These are the ones I remember off the top of my head. I'm sure there is more.
Although my residency pushed me hard, and I had many long and hard nights... the training was unbelievable. I'd get home sometime around 7:30 am, look back at some of the nights and think to myself.... Wow... you can't get any more real than that. I'm thankful of the experience as I usually run at 55bpm in the OR despite what might be going on.
Well... so far today, 1 fasciotomy 2/2 compartment, 2 hemi's, 2TFN's, now got an ORIF of a radial fx.... OB has been quiet...this is unsusual... but I'lll still get some sleep. That is one BIG differnce btw PP and the 'ol big house.
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I'm a new attending at a major level I trauma center. Took me about three months until my first intraop death and most of my coworkers were shocked I had made it that long.
It's all about where you work.
It's all about where you work.
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I don't have an opinion, but here's what Tom Jones has to say about it:
http://www.youtube.com/watch?v=QrwO8b9iq34
http://www.youtube.com/watch?v=QrwO8b9iq34
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About 1 intraop death every 2 years for me. High acuity cases, Cardiac and Trauma.
Many more deaths per year if you count the first 24 hours ( which you should).
I'm not counting ASA5E trauma cases in the above
Many more deaths per year if you count the first 24 hours ( which you should).
I'm not counting ASA5E trauma cases in the above
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My residency was a busy level one trauma...and I had my unfair share of these...including that patient rolling up from the ED, chest cracked, active heart massage, rapid transfuser going, no pulse on arrival and yet we still take him because he's young and maybe could survive if they closed the hole on his heart and/or aorta...no matter the anoxic brain injury from no hgb/oxygen carrying capacity 🙄
Good trauma experience...hours logging those blood product transfusion sheets
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How profound, nurse. Now beat it!
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Counting expected / postop deaths my tally is higher, as I would expect everyone's is.
It's the unexpected ones that hurt ... my CA-1 botched trach case and recent DRT pulmonary embolism (which I suspected/knew wasn't my fault, but didn't know for sure it was a PE for several days) were the ones I lost sleep over.
🙂 Now now ... it's the SDN of course, but we should be more friendly to midlevels who don't show up trolling.
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I would argue that it is the healthcare community as a whole (surgeons, anesthesiologist) are at fault if they present their pts with that frame of reference b/c some of these pt can be saved....maybe some day these pts will have a much better chance of survival secondary to advancements in medicine driven by physician research...pubmed "asanguinous hypothermic (10 degrees C) circulatory arrest" some pretty interesting stuff being done in animal models which will someday be done in humans (wouldnt be surprised if it has already been done)
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I feel just fine, nursey. Just hate CRNAs is all.
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I've lost their gown and cap a few times, but never the entire patient.
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