More on why anesthesia is (or is not) safer
Posted by Clark Venable on 12/22/2005
Walter Olson responded to my earlier post and I feel I need to clarify what I meant. I thank him for pointing out (gently) the error of my words.
First off, I trained in the early 1990's after the advent of improved monitoring such as pulse oximetry and end tidal gas monitoring. My statement that 'overdose risk is not and was never a cause of patient morbidity and mortality in my field' was overly broad and, as Olson points out, incorrect.
The point I tried to make (though not well) was that overdose is not something we presently worry about and does not explain the apparent increase in awareness under anesthesia. What can explain it (in part) is the use of muscle paralyzing drugs (even when they are not absolutely necessary) often together with medical errors such as empty vaporizers (inhaled anesthetic delivery source), incorrectly installed vaporizers, or other human error.
Though Google turns up many hits on anesthesia and overdose, these tend to be written by non-anesthesiologists for the lay public and should not be taken as evidence that anesthetic overdoses is a cause of malpractice claims (though, admittedly, it is a term that most juries readily understand)
Walter, if you're reading this, I'd love to be able to read more about how the legal system portrays us during trials. Any pointers?
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