Dr. Nillal Fatima, MI)
Consultant lntensivist, JD Hospital, Shahkot
You have induced anaesthesia to a young patient undergoing elective abdominal surgery.
The patient is successfully intubated and relaxed, to be ventilated by lPPV. Suddenly
the patient turns blue, and the oximeter attached to the patient showed a rapid fall
of saturation
[WpProQuiz 16]
This cliniquiz is based on viva voce questions asked during an MCPS practical examination. A fresh incident of similar nature had occurred in a civil hospital at Lahore in which oxygen cylinder was wrongly filled with nitrous oxide. Even when the anesthesiologist was apparently giving 100% oxygen, he was actually ventilating the patient with 100% nitrous oxide. The result was obvious. The patient died of cardiac arrest secondary to absolute hypoxia. This possibility should always be borne in mind.
Even the piped gas supply is not immune to this sort of anesthetic mishap, especially after repairs.
The only answer to this problem is the use of ‘OXYGEN ANALYZERS’ to monitor inspired oxygen concentration, and/or a very fast, rather instantaneous reflex action by the anesthesiologist, if the life of the patient is to be saved. The practice of anesthesiology must go high-tech now, if we have even the slightest concern for the human life. The gas company concerned must face criminal proceedings.
