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围手术期死亡:其影响与处理

Perioperative death: Its implications and management.

作者信息

Attri J P, Makhni R, Chatrath V, Bala N, Kumar R, Jain P

机构信息

Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.

Department of Psychiatry, Government Medical College, Amritsar, Punjab, India.

出版信息

Saudi J Anaesth. 2016 Oct-Dec;10(4):436-439. doi: 10.4103/1658-354X.177338.

Abstract

Death to most people is a major life event. Nothing in this world prepares us to face and manage the perioperative death although the majority of anesthesiologists will be involved in an intraoperative death during the course of their careers. Whether death on the table was expected or occurred when least expected or may be even later, the anesthesiologist is most likely to be affected emotionally, physically in his personal life, and as well as will have an influence on his professional career. Anesthesiologists as perioperative physicians are likely to experience death on the operating table at some time in their careers. In case of perioperative death, meticulous record keeping including time of occurrence of event and methods and medications used during resuscitation, nature of the problem, and all sequence of events should be adopted to breaking bad news with relatives and blame game should be avoided. The anesthesiologist and the relatives of the patient should also be given emotional support to come out of this untoward event. In this article, we have highlighted the various factors and causes leading on to perioperative death and if in case such an event occurs, what are the protocols to be followed, including medicolegal aspects, giving emotional support to the concerned anesthesiologist, dealing with the relatives of the patient sympathetically, etc. We have also enumerated the various precautions to be taken to prevent perioperative mortality in this article.

摘要

对大多数人来说,死亡是一件重大的人生事件。尽管大多数麻醉医生在其职业生涯中都会遇到术中死亡的情况,但世界上没有任何事情能让我们做好面对和处理围手术期死亡的准备。无论手术台上的死亡是预期的,还是在最意想不到的时候甚至更晚发生的,麻醉医生很可能在情感、个人生活的身体方面受到影响,并且这也会对其职业生涯产生影响。麻醉医生作为围手术期医生,在其职业生涯的某个时候很可能会在手术台上经历死亡。在围手术期死亡的情况下,应采用细致的记录,包括事件发生的时间、复苏过程中使用的方法和药物、问题的性质以及所有事件的顺序,以便向亲属透露坏消息,同时应避免相互指责。还应为麻醉医生和患者家属提供情感支持,帮助他们走出这一不幸事件。在本文中,我们强调了导致围手术期死亡的各种因素和原因,以及如果发生此类事件应遵循的方案,包括法医学方面、给予相关麻醉医生情感支持、同情地对待患者家属等。我们还在本文中列举了预防围手术期死亡应采取的各种预防措施。

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