7 Decision making
Klein (1993, 1995, 1998) describes versions of recognition-primed decision making. At the basic level, the decision maker recognises the situation and knows an appropriate response. When the situation is more…
3 Situation awareness
Maintenance of SA demands vigilance and good monitoring at all times. It may easily be lost if agreed actions, protocols or guidelines are not followed or do not have the…
1 Introduction to human factors in medicine
Background to Clinical Error The United States was the first country to investigate clinical error systematically. In 1984, Brennan et al. looked at 30,121 admissions to New York hospitals and…
4 Leadership and teamworking
Box 4.1 A junior doctor was asked to examine a child with blunt chest trauma, and correctly identified that the chest movement was asymmetrical and that the percussion note was…
5 Personality and behaviour
Box 5.1 A senior surgeon walks into the emergency department to review a patient in the resuscitation room. He does not introduce himself and is not wearing any identification, though…
FOR OBSTETRIC AND GYNECOLOGIC SURGERY
ANESTHESIA FOR LABOR AND DELIVERY • Nonpharmacologic analgesia choices: Hypnotherapy, hydrotherapy, and transcutaneous electrical nerve stimulation (TENS) • Pharmacologic analgesia: Inhalation analgesia, parenteral opioid analgesia (fentanyl, nalbuphine), pudendal block, paracervical…
ELECTROLYTES, & TRANSFUSION THERAPY
(LR, NS, & hetastarch → shown to ↑ neutrophil activation; blood, 7.5% hypertonic saline, & albumin did not have this effect) Figure 9-1. Assessment of volume status. Colloid osmotic pressure (COP)…
ANESTHESIA
• Infant chest wall deforms easily → because of cartilaginous structure • Accessory muscles provide limited support (poor anatomic rib configuration) • Infantile diaphragm contains 20–25% of fatigue-resistant type I…
MANAGEMENT AND DISCHARGE
Initial Diagnosis & Management 1. Examine & stabilize—check Airway, Breathing & Circulation 2. Fluid resuscitate—obtain adequate venous access 3. Review data—patient history, anesthesia record, surgical procedure, estimated blood loss, PACU…
