It is the patient who suffers in the end in untrained hands.....

[toughlife]

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CHICAGO - A 5-year-old Chicago girl who never awoke from her sedation during a visit to the dentist died Wednesday at Children's Memorial Hospital, a hospital official said.

Kindergartner Diamond Brownridge had been in a coma and on life support since the weekend dentist visit, said Julie Pesch, a spokeswoman for Children's Memorial Hospital.

Family members have said Diamond received a triple dose of sedatives — an oral agent, an intravenous drug and nitrous oxide gas — during Saturday's exam at Little Angel Dental. The girl was having two cavities filled and caps placed on her lower front teeth.

The girl's mother, Ommettress Travis, has said she was asked to leave the room during the half-hour procedure. When she returned, her daughter was lying in the dental chair, not breathing, Travis said.

The girl's dentist, Hicham Riba, was certified to administer anesthesia to patients and his state license was current, said Susan Hofer, a spokeswoman for the Illinois Department of Financial and Professional Regulation.

Speaking to the Chicago Sun-Times before the girl died, the 40-year-old Riba said he was traumatized by what happened. "I don't think I will ever go back to a normal life after an experience like this," he said.

The telephone rang unanswered at Riba's home Wednesday night.

http://news.yahoo.com/s/ap/20060927/ap_on_re_us/dentist_coma

 

[jetproppilot]

CHICAGO - A 5-year-old Chicago girl who never awoke from her sedation during a visit to the dentist died Wednesday at Children's Memorial Hospital, a hospital official said.

Kindergartner Diamond Brownridge had been in a coma and on life support since the weekend dentist visit, said Julie Pesch, a spokeswoman for Children's Memorial Hospital.

Family members have said Diamond received a triple dose of sedatives — an oral agent, an intravenous drug and nitrous oxide gas — during Saturday's exam at Little Angel Dental. The girl was having two cavities filled and caps placed on her lower front teeth.

The girl's mother, Ommettress Travis, has said she was asked to leave the room during the half-hour procedure. When she returned, her daughter was lying in the dental chair, not breathing, Travis said.

The girl's dentist, Hicham Riba, was certified to administer anesthesia to patients and his state license was current, said Susan Hofer, a spokeswoman for the Illinois Department of Financial and Professional Regulation.

Speaking to the Chicago Sun-Times before the girl died, the 40-year-old Riba said he was traumatized by what happened. "I don't think I will ever go back to a normal life after an experience like this," he said.

The telephone rang unanswered at Riba's home Wednesday night.

http://news.yahoo.com/s/ap/20060927/ap_on_re_us/dentist_coma

😱 😱

Heres a little personal info for you guys which is testament to how I feel about intra-office sedation by non-anesthesia personnel.....

I'm probably gonna get a vasectomy soon by a urologist I work with...it takes him 15 minutes in his office and he gives IV midazolam before the case.

One of my CRNAs is coming with me.

 

[chesterfield]

Diamond received a triple dose of sedatives — an oral agent, an intravenous drug and nitrous oxide gas http://news.yahoo.com/s/ap/20060927/ap_on_re_us/dentist_coma

It must be the "triple dose" that was the problem. Not doing anesthesia with out standard ASA monitors by a provider not trained in anesthesia in an out patient setting without adequate resuscitation equipment.

 

[Induc(junc)tion]

It must be the "triple dose" that was the problem. Not doing anesthesia with out standard ASA monitors by a provider not trained in anesthesia in an out patient setting without adequate resuscitation equipment.

I was thinking the same thing

 

[aredoubleyou]

:I'm probably gonna get a vasectomy soon .[/B]

The old lady hasn't quite convinced you yet

I worked with a urologist who gave nothing more than some local and lots of verbal support

 

[jetproppilot]

The old lady hasn't quite convinced you yet

I worked with a urologist who gave nothing more than some local and lots of verbal support

I'm gonna need a little more than verbal support with a scalpel intruding my scrotum, dude.

Yeah, I'm a tough guy but.....scalpel....clamps....ON DA SCROTUM?????

Ronnie the Urologist: "BILL!! BILL!!! RELAX! RELAX! IGNORE THE TITANIUM INVADING THE MOST SENSITIVE PART OF YOUR BODY!!!

at this point, hopefully, Brian CRNA has a little "stuff" in his pocket he's brought along that he can administer intravenously to augment the "verbal support" since said scrotum is now in a vice.....My airway is lost? No big deal. Brian CRNA can manage an apneic fire-ant airway. So managing mine should be no big deal.....SEE? I'VE COME PREPARED FOR THE SCROTAL CLAMPAGE...

Talkin' about having a dude by the balls....

 

[jetproppilot]

The old lady hasn't quite convinced you yet

Aint that the truth.

But she aint the one gettin' up every morning at 0520 to go to work....😎

And yours truly realizes that one's wealth is inversely proportional to the number of kids one produces....I've got four....TIME TO CLIP DA VAS.....

 

[DrDre']

When I was a medic, my first code ever 2 weeks on the job was a peds code at a DDS office. He tried oral ativan, waited, not enough result, then IM ketamine, not enough, then IV brevital. Then after inducing a GA, he thought she went into laryngospasm so he suxed her, twice. He was unable to intubate and just mask ventilated her (oropharynx only I think).
When I arrived, I intubated her very easily (my first real tube ever, high stress, in front of mom who had no idea what was going on until myself and 3 firefighters barged in...). She coded, got her back and she seized for 3 days> dead...

I hate that people think it is easy to do "conscious sedation" or MACs.

I will never get such a thing without a chaperone to monitor and raise hell if necessary!

 

[SleepIsGood]

Funny this was brought up at our hospital Tough.

Reason being, we have DDS "residents" rotating through our Anesthesiology Dept for one month. Here's their schedule. They come in at maybe 10:30AM to 'sign in' and then leave around 12 noon. Clearly this is a joke rotation for them.

During my ACLS classes when we started, NONE of them knew anything about reading EKGs, chest compressions, intubating,etc (neither did most of the med students). The difference I think is that anesthesiologists/medical doctors get some sort of training of atleast at bagging a pt. I think this particular kid could have been saved if the DDS would have atleast put in an oral airway and bagged the pt. More and more DDS's are starting to use conscious sedation in their practices (just listen to the radio for christ's sake) and they have next to nil experience in resuscitation.

In that Time magazine article, I think it was Ron Miller who stated that he used midazolam all the time without probs. However, one time in his career he had a pt code s/p administration of versed. Bottom line, didfferent ppls bodies have different reactions to drugs which we can not predict.

I think these DDS's do not realize how one's airway can become compromised in no time. Further, it seems they don't get the proper training to intervene in the event something happens. Doing a 'joke' anesthesia rotation doesnt count. The scarier thing is that the anesthesia rotation is done ONLY if DDS's decide to do a one year residency. FYI, most DDS's graduate from dental school and go straight into practice. Could any of you imagine graduating medical school and going straight into practice 😱

Where are the professional regulating agencies when it comes to regulating who can sedate?? Again, Anesthesiologists should be the only ones sedating pts outside the OR, we know how to manage the airway best. It's not just about job security, it's also about who can do the best job for the patient.

 

[IN2B8R]

I hate that people think it is easy to do "conscious sedation" or MACs.

I will never get such a thing without a chaperone to monitor and raise hell if necessary![/QUOTE]

You're absolutely right. A case in point: just today, I had a "straight forward" endoscopy on a guy who had an abdominal sarcoma. 4 mL's of Propofol and the guy is out! Apnea for 2 minutes, I kid you not. And we're talking about a guy who is only 43 yrs old, not 90 years old (approx. 70 Kg's). Good thing I recognized that he was intravascularly dry before we got started; knowing dehydration ahead of pushing Propofol in this ASA setting is what saved this guy's life. How many non-anesthesiologists would have picked this up ahead of time and prevented further apnea? How many would have over-sedated this guy to further apnea and death? I often wonder....

 

[VolatileAgent]

get called to "airway emergencies" more often than we should in our hospital secondary to oversedation. it's funny how some people think it's not possible to, for all intents and purposes, induce ga with midazolam and fentanyl.

 

[Noyac]

Aint that the truth.

But she aint the one gettin' up every morning at 0520 to go to work....😎

And yours truly realizes that one's wealth is inversely proportional to the number of kids one produces....I've got four....TIME TO CLIP DA VAS.....

I got no kids and lots a toys therefore my wealth is relative.

 

[VentdependenT]

😱 😱

Heres a little personal info for you guys which is testament to how I feel about intra-office sedation by non-anesthesia personnel.....

I'm probably gonna get a vasectomy soon by a urologist I work with...it takes him 15 minutes in his office and he gives IV midazolam before the case.

One of my CRNAs is coming with me.

Make sure you leave a donation at the "bank" before you cash out your "future earnings".

 

[bluewater]

I am currently a CA 1, our OMFS residents spend 6 months doing anesthesia. These guys run their own rooms, once they are deemed able.

They come in every morning at 530 and set up rooms, see pts, start IVs, etc.

These guys recieve much more training than most DDS/DMDs.

 

[jetproppilot]

Make sure you leave a donation at the "bank" before you cash out your "future earnings".

 

[Noyac]

USA Today posted this case today. In the title of the article they say "Anesthesia" not sedation at a dentist's office or anything like that. This is unfortunate since many will feel that an anesthesia person was involved and not just a dentist.👎

 

[SleepIsGood]

USA Today posted this case today. In the title of the article they say "Anesthesia" not sedation at a dentist's office or anything like that. This is unfortunate since many will feel that an anesthesia person was involved and not just a dentist.👎

Noyac

Interesting you mentioned that. Check this link out: http://www.suntimes.com/news/metro/76668,cst-nws-autopsy28.article

In the title "Anesthesia" is referred to as the cause of death. My dad and many of my uncles called me and were like "you guys should be careful when giving anesthesia, did you read what happened in the paper". I think the general public (ie "lay people") perceive this to be the mistake of an anesthesiologist or a side effect of anesthesia.

Yes, to all you that are going to counter my point by saying, well anesthesia means "removal of pain", I think if you are logical you realize that the general public doesnt see that "anesthesia" and "anesthesiologists that perform anesthesia" are different.

I think this would be a perfect opportunity for the ASA to step it up a notch and write a counter article stating the importance of BOARD CERTIFIED ANESTHESIOLOGISTS in the adminstration of anesthesia both in inpt and outpt settings.

 

[toughlife]

Noyac

Interesting you mentioned that. Check this link out: http://www.suntimes.com/news/metro/76668,cst-nws-autopsy28.article

In the title "Anesthesia" is referred to as the cause of death. My dad and many of my uncles called me and were like "you guys should be careful when giving anesthesia, did you read what happened in the paper". I think the general public (ie "lay people") perceive this to be the mistake of an anesthesiologist or a side effect of anesthesia.

Yes, to all you that are going to counter my point by saying, well anesthesia means "removal of pain", I think if you are logical you realize that the general public doesnt see that "anesthesia" and "anesthesiologists that perform anesthesia" are different.

I think this would be a perfect opportunity for the ASA to step it up a notch and write a counter article stating the importance of BOARD CERTIFIED ANESTHESIOLOGISTS in the adminstration of anesthesia both in inpt and outpt settings.

Already shared article with ASA PR folks and asked to use it to highlight anesthesiologists' safety record.

 

[Monty Python]

I'm gonna need a little more than verbal support with a scalpel intruding my scrotum, dude.

Yeah, I'm a tough guy but.....scalpel....clamps....ON DA SCROTUM?????

....

Does this surgeon have an operating microscope in his office? Oops, I thought this was the microsurgery forum. Sorry.

 

[Zoom-Zoom]

Does this surgeon have an operating microscope in his office? Oops, I thought this was the microsurgery forum. Sorry.

Zing!

 

[UTSouthwestern]

Does this surgeon have an operating microscope in his office? Oops, I thought this was the microsurgery forum. Sorry.

You mean electron microscope, right?

 

[Laryngospasm]

You mean electron microscope, right?

In jets defense the size of the beans doesnt always relate to the sausage🙂

 

[VentdependenT]

You mean electron microscope, right?

they are gonna need an argon lazer to blast through jets vas.

 

[jetproppilot]

Does this surgeon have an operating microscope in his office? Oops, I thought this was the microsurgery forum. Sorry.

Uhhhhhh, ha ha Trin.

OK buddy.

Ya got me on that one.

 

[jetproppilot]

You mean electron microscope, right?

OK ya'll, UT is easy to find in the mens room.

He's the only one wearing loops at the urinal.

Oh, and, uhhh, I've yet to see an oriental porn star.....HAHAHHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAAHAHHAHAHAAAHAH

gees I crack myself up.

 

[jetproppilot]

they are gonna need an argon lazer to blast through jets vas.

TELL 'EM VENTY!!! I NEED SUPPORT FIRE!!! I'M TAKING ENEMY FIRE FROM ALL QUADRANTS!!!

 

[Monty Python]

OK ya'll, UT is easy to find in the mens room.

He's the only one wearing loops at the urinal.

Oh, and, uhhh, I've yet to see an oriental porn star.....HAHAHHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAAHAHHAHAHAAAHAH

gees I crack myself up.

Get 'em Maverick !

Signed, Goose

PS. the F-14s were officially retired last week 🙁

 

[jetproppilot]

Get 'em Maverick !

Signed, Goose

PS. the F-14s were officially retired last week 🙁

"ANY YOU BOYS SEEN AN AIRCRAFT CARRIER AROUND HERE?"

 

[militarymd]

OK ya'll, UT is easy to find in the mens room.

He's the only one wearing loops at the urinal.

Oh, and, uhhh, I've yet to see an oriental porn star.....HAHAHHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAAHAHHAHAHAAAHAH

gees I crack myself up.

Jet,

I'm 2 inches......





































































from the floor,

Your friend,

Hung

 

[jetproppilot]

Jet,

I'm 2 inches......















from the floor,

Your friend,

Hung

HAHAHHAHAHAHAHA

I knew that was coming, even before I scrolled down.

 

[DropkickMurphy]

I'm gonna need a little more than verbal support with a scalpel intruding my scrotum, dude.

Yeah, I'm a tough guy but.....scalpel....clamps....ON DA SCROTUM?????

Ronnie the Urologist: "BILL!! BILL!!! RELAX! RELAX! IGNORE THE TITANIUM INVADING THE MOST SENSITIVE PART OF YOUR BODY!!!

at this point, hopefully, Brian CRNA has a little "stuff" in his pocket he's brought along that he can administer intravenously to augment the "verbal support" since said scrotum is now in a vice.....My airway is lost? No big deal. Brian CRNA can manage an apneic fire-ant airway. So managing mine should be no big deal.....SEE? I'VE COME PREPARED FOR THE SCROTAL CLAMPAGE...

Talkin' about having a dude by the balls....

That's the funniest damn thing I've read in a long time......

 

[OB1🤙]

http://www.msnbc.msn.com/id/15091116/

CHICAGO - State regulators have suspended the license of a dentist whose 5-year-old patient fell into a coma in his office and later died.

Dr. Hicham Riba’s practices posed an “imminent danger to the public,” the Illinois Department of Financial and Professional Regulation said Friday. It said Riba failed to properly monitor Diamond Brownridge’s blood pressure, pulse and respiration during her treatment Sept. 23 at his storefront clinic.

The complaint said Riba recorded that Diamond was “alert and responsive” on discharge, although her mother claims to have found her comatose in the dental chair.

Diamond died Wednesday at Children’s Memorial Hospital in Chicago. She had been on life support for four days after her visit to Little Angel Dental to have some teeth filled and others capped.

Riba’s attorneys confirmed the suspension late Friday pending an Oct. 13 hearing.

“Diamond’s loss is tragic,” Riba said in a statement. “As we have stated before, we have fully cooperated with the investigation and will continue to do so.”

Riba, 40, faces up to $10,000 in fines for each of four violations, which include making false or fraudulent representations, professional incompetence and gross malpractice.

State regulators said Diamond received two injections of diazepam or Valium within five minutes, followed by oral Valium, lidocaine, several other medications, and nitrous oxide. The regulators did not say whether the combination or the dosages were appropriate for the 35-pound girl.