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...
| Publicado en: | AANA Journal Vol. 82; no. 1; pp. 20 - 25 |
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| Autores principales: | , , |
| Formato: | case study pictorial tables/charts Journal Article |
| Publicado: |
American Association of Nurse Anesthetists
Feb2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=94324498&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 94324498 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00946354 GLR jtl: AANA Journal issn: 00946354 maglogo: N pubinfo: dt: Feb2014 vid: 82 iid: 1 pid: 11824 pub: American Association of Nurse Anesthetists place: Park Ridge, Illinois artinfo: ui: 94324498 94324498 104019804 94324498 ppf: 20 ppct: 5 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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