MedMal Confidential # 03 - US Healthcare's Dirty Little Secret

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Hey???- David here!

Happy May 1st to you and the other 6,505?Insiders?reading this.

Here’s what we’ll be uncovering in this edition of?MedMal Confidential?…

Today’s ‘Insider Information’ At-A-Glance

Read Time: 2.6 minutes

??Musings: The 5 levels of sedation (and why they matter)

?Litigation: Blood Pressure Limbo - “How low can you go?”

??News: US Healthcare’s dirty little secret

Read on for your insider info …

??Musings:?The 5 levels of sedation (and why they matter)

When most people think of anesthesia, they think of it as a binary:

• Option A: wide awake
• Option B: snoring

But the truth is, there are levels to it:

1. Unsedated
2. Minimal sedation (anxiolysis)
3. Moderate sedation/analgesia (conscious sedation)
4. Deep sedation/analgesia
5. General anesthesia

There’s also numerous clinical factors being evaluated:

1. Responsiveness
2. Airway
3. Spontaneous ventilation
4. Cardiovascular function

Why does this matter?

Because complications arise from oversedation and airway compromise.

And some healthcare workers are?much better trained to deal with it?than others.

Take a look at the intervention required for different levels of sedation:

The Insider Info

Anesthesia is a continuum, not a binary. And patients can reside at different levels of sedation at different points of a procedure.

• The same medications may achieve drastically different results when used across different patients, illnesses, and ages,
• “I always give this dose” and “My standard dose is” are obsolete concepts

The intention to achieve a certain level is only half the equation

• The final achieved level of sedation is more important

Countless medical malpractice lawsuits stem from a failure to monitor and failure to rescue patients that go “too deep” on the sedation continuum

• A team administering moderate sedation must have the skill and knowledge to “rescue” an oversedated patient…

Unfortunately, they often don’t.

• A team administering moderate sedation must dose medication appropriately, be vigilant, and document accordingly…

Unfortunately, they often don’t.

Excessive sedation by an undisciplined team may lead to catastrophic patient outcomes, opening that team up to medicolegal liability and ...

P.S.

Thanks for reading a preview of?MedMal Confidential?issue?#03, Published on May 1st

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