Bilateral Tension Pneumothorax Following Equipment Improvisation.

This case report describes an unexpected event that took place as a result of using improvised equipment. The patient, a 16-year-old female undergoing complex oral surgery, suffered bilateral pneumothorax following the improper use of an airway support device. During the immediate postoperative peri...

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Publicado en:AANA Journal Vol. 82; no. 1; pp. 20 - 25
Autores principales: Zambricki, Christine, Schmidt, Carol, Vos, Karen
Formato: case study pictorial tables/charts Journal Article
Publicado: American Association of Nurse Anesthetists Feb2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2014
      vid: 82
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      pub: American Association of Nurse Anesthetists
      place: Park Ridge, Illinois
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        atl: Bilateral Tension Pneumothorax Following Equipment Improvisation.
      aug:
        au:
          Zambricki, Christine
          Schmidt, Carol
          Vos, Karen
        affil: Director of nurse anesthesia, William Beaumont Hospital
      sug:
        subj:
          Pneumothorax Etiology
          Postoperative Complications Etiology
          Barotrauma, Pulmonary Etiology
          Oxygen Therapy Adverse Effects
          Oxygen Delivery Devices Adverse Effects
          Advanced Practice Registered Nursing
          Anesthesia Nursing
          Root Cause Analysis
          Risk Management
          Surgery, Oral
          Surgical Patients
          Post Anesthesia Care Units
          Intubation, Intratracheal
          Perianesthesia Nursing
          Certified Registered Nurse Anesthetists
          Workload
          Attention
          Teamwork
          Communication
          Inventories
          Transfer, Intrahospital
          Inpatients
          Nursing Outcomes
          Female
          Adolescence
          Adolescent: 13-18 years
          Female
      ab: This case report describes an unexpected event that took place as a result of using improvised equipment. The patient, a 16-year-old female undergoing complex oral surgery, suffered bilateral pneumothorax following the improper use of an airway support device. During the immediate postoperative period with the patient still intubated, oxygen tubing was attached to a right angle elbow connector with the port closed and 10 L/minute oxygen flow was administered to the patient in a manner that did not allow the patient to exhale. Within seconds, pneumothorax was apparent as the patient's vital signs deteriorated, visible swelling was noted in the shoulders and neck, and there was an absence of breath sounds on auscultation. This case study has application beyond the immediate discussion of bilateral pneumothorax, serving as a caution about the unintended consequences of equipment improvisation. In addition to highlighting the hazards of providing patient care with a non-standard device, this study also provides a powerful example of the human factors that can contribute to medical errors in the healthcare setting.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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