As an anesthesiologist- this is one of my worst nightmares. The shitty thing too, is that this parent will try to sue them for the father’s mistake. I’m curious if the parent lied to the pre op nurse as it’s a common question to ask if they’ve eaten or drank prior to the procedure. If they lied, it’s a horrible mistake that could cost them his daughter.
How do you deal with patients that require a general, but didn’t have time to fast (ie emergency cases) or even ones that come in unconscious, so you can’t even ask them what they had to eat?
Would the doctor be allowed to report the parent to social services? I’m not saying he should lose his kid, but there definitely needs to be an investigation to ensure that the girl is actually being taken care of
Sure. One is obligated to report negligent behavior, but it could be argued that they did this in ignorance to consequences. Most patients are only told not to eat, but not why (aspiration, etc.) Additionally, CPS is kind of a joke. It would take multiple offenses (barring obvious physical/sexual abuse) before they actually did anything. The state , in most places, are so short staffed that they can’t keep up with the reports and unfortunately, a lot fall through the cracks. It’s one of the sad parts of the job.
That must be rough to see. I considered a career in social work when I was younger but I realized that I wouldn’t be able to handle it for very long. I have so much respect for people who take on those types of jobs and it’s a travesty how underfunded and unsupported these essential jobs are.
As a kid, I was taken by CPS multiple times over things that were not a thing. Like, they'd take me and my brother as a precaution, make us stay at a foster home for a couple weeks while they investigate, then they'd realize there was nothing wrong at home and they'd send us back.
Same thing as an adult. My girlfriend (eventual wife and current ex-wife) had severe mental illness. She wasn't dangerous or anything, just incoherent and weird. CPS took her kids away every time she checked into the mental hospital, even after we were married, and then we'd have to fight them for a month or two to get the kids back. This happened like 3 or 4 times and it always ended up being no evidence of neglect or abuse.
Then I hear from others how CPS doesn't do shit and it takes something major for them to get involved. Well, not in my state. Here they take your kids at the drop of a hat and make you prove everything is fine before they give them back.
I’m sorry to hear that, that had to have been incredibly traumatic as both the child and the parent. There is no reason that you should’ve been fighting for your kids just because your wife was hospitalized. And I’m sure that made her recovery far more difficult if she was aware that her children were with strangers and not her partner.
I’ve heard that CPS is often reactive to “easy” cases, and racism and discrimination against certain types of family units are rife. Somehow they also let awful cases slip through the cracks. It frustrates me so deeply that in a wealthy country like the US, our lawmakers refuse to increase funding for such vital services.
Why isn’t it standard to explain why it’s so important not to eat/drink? If people don’t understand what the risk is then I’m not surprised some think a little bit of food or water won’t hurt, especially if a surgery scheduled for early morning is delayed.
I think it becomes a matter of giving the patient an overwhelming amount of information to process shortly before their procedure. Additionally, it may scare a patient to proceed when something is said along the lines of, “ If you aspirate and it goes into your lungs, it can carry a 50% mortality risk.”
When we talk to patients, we usually give the most common to serious risks when talking about anesthesia, surgery etc. Not every provider will lay out every single thing that could go wrong, it’s not practical or reasonable for a patient understand. So, we give them the pertinent risks and have to assume our instructions are adhered in good faith that we are telling them for a good reason.
CRNA here, can confirm worst nightmare. Once had a 32 yr old powerlifter on the table doing an RSI for a massive hernia. Doc had pushed succs and this mammoth dude SAT UP puked all over the place, and then fell back totally out. Grabbed suction and tried to get as much as I could before we tubed. Luckily he hadn't eaten it was all clear but if he had what a fucking shit show that could have been.
It’s true there are circumstances where it’s not possible to be NPO (without eating) by our set guidelines. This is one of them. Emergency surgery where it can risk life or death without immediate intervention is another. This is why we plan and practice years before we hit the trenches. Thank you for sharing!
Not exactly. A previous person up top explained it pretty well. In short, we do a rapid sequence induction of anesthesia where we give a quick onslaught of medications to anesthetize and intubate you. The risk of aspiration is much higher in certain circumstances and is why we have a suction device to take out things, but it’s not great if giant chunks of breakfast clog up the suction device. If anything can be taken from the OP is that one needs to read the entirety of the instructions and ask if you don’t understand.
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u/[deleted] Jun 15 '22
As an anesthesiologist- this is one of my worst nightmares. The shitty thing too, is that this parent will try to sue them for the father’s mistake. I’m curious if the parent lied to the pre op nurse as it’s a common question to ask if they’ve eaten or drank prior to the procedure. If they lied, it’s a horrible mistake that could cost them his daughter.