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Have you ever encountered such an interesting thing in anesthesia work?

 Last Update: 2021-11-03
 Source: Internet
 Author: User

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There are all interesting things in anesthesia work

One day, during the preliminary examination at the preoperative anesthesia assessment center, I met such an old lady

Patient XXX, 79 years old, hypertension for decades, history of surgery: cholecystectomy; the next day underwent thoracoscopic lobectomy on the right side

Ask the family members who learned that the patient was not accompanied by the preoperative anesthesia assessment to sign

So I asked the old lady, where are your family members? This is the preoperative anesthesia assessment center.

Old lady: My family did not come, what should I do?

I’m the only one, can’t you sign?

I will have surgery tomorrow.

I immediately calmed the excitement of the old lady.

Since you are already 79 years old, we need to ask your family to sign from a safe point of view.

So, the old lady hurriedly said to me, wait a moment, and hurriedly walked out of the preoperative anesthesia evaluation center, and suddenly pulled in a patient who was also wearing a medical coat, and said to me: look, let me Can this brother sign for me?

I asked: Old lady, is this your family member?

Old lady: No, but, I can’t find anyone, my family is not there, and the child is not with me, I’m the only one!

Can the waiting area

Find someone else's

Family members or patients

Do you sign it for me?

Article 33 of the "Regulations on the Administration of Medical Institutions of the People's Republic of China " stipulates that medical institutions must obtain the patient's consent when performing operations, special examinations or special treatments, and shall obtain the consent and signature of their family members or related persons; the patient's opinions cannot be obtained At the time, the consent of family members or related parties should be obtained and signed

Preoperative anesthesia can be signed by the patient himself, but from the perspective of China's national conditions, for children and the elderly, it depends on the specific circumstances, and the general guardian's signature is more appropriate

The general order of signature validity is:

Signature of the person, signature of the client, and signature of authorization in case of emergency

My signature: the patient himself

Signature of the client: The spouse, parents, children, etc.

Emergency authorization signature: In an emergency, the patient has lost consciousness or lost judgment, so colleagues and leaders can sign on their behalf

The problem caused by the above story!

Do I have to have family members for the preoperative anesthesia signature?

If a major operation or general anesthesia operation requires the patient and family members to be informed of the risk of anesthesia, sign and agree
.

1.
Surgery, emergency surgery, and some major operations often have certain risks.
Patients will lose consciousness when undergoing general anesthesia.
If there is an emergency during the operation, it is impossible to wake the patient and ask the patient for their opinions.
It needs to be entrusted to relatives in advance, such as the patient’s lover, parents, children, etc.
, and the close relatives can better make decisions closer to the patient’s true wishes
.

Once an unpredictable situation occurs, both the anesthesiologist and the surgeon need to communicate with the patient’s family in advance to obtain further treatment plans.
Especially for some highly malignant tumors, it is very likely that the surgical method will be changed.
It is impossible to see the depth of infiltration very intuitively, and some cannot make accurate judgments.
The original operation method needs to be changed.
The thoracotomy plan completely cures the surrounding extensive infiltration.
At this time, it is necessary to communicate with the patient's family to obtain the patient's family member.
Consensus and understanding of the disease , avoid unnecessary disputes, and wait for the patient’s family members to sign and confirm before proceeding to the next step
.
By signing, the patient’s family members can fully understand and inform the occurrence and development of the disease, the method of anesthesia, and the risk of anesthesia
.

2.
Under normal circumstances, the family members of the patient only have the right to know the patient’s condition.
However, if the patient needs major surgery or special treatment or general anesthesia, the family member of the patient has the right to know and cannot obtain the patient’s opinion.
At the time, the consent of the patient’s family members must be obtained and signed
.

The patient’s family members have the right to know, and as medical staff, they have the obligation and responsibility to communicate with the condition and obtain the support and trust of the family members
.

3.
Some patients come to the hospital for surgery without their family members knowing.
Then, in this case, the patient will be left unattended after the operation, which is not conducive to the treatment and recovery of the patient
.

What if there are no family members?

Can't it be operated on?

According to the provisions of Article 56 of the Tort Liability Law: if the patient or his close relatives are unable to obtain the opinions of the patient or his close relatives due to emergency situations such as rescuing a patient who is dying of life, the corresponding action can be implemented immediately with the approval of the person in charge of the medical institution or the authorized person in charge Medical measures
.

For patients who will face life-threatening situations without surgery, if a critical situation arises, if they cannot contact their family members or cannot wait for their arrival at this time, or the family members are afraid to sign and are undecided or unwilling to treat, if they do not immediately undergo surgery There will be life-threatening.
At this time, the hospital’s medical behaviors of saving lives and helping the wounded cannot use " signature " as a necessary condition.
The behavior at this time should save lives.
Although it has not been signed and approved by the family, the ultimate mold form alone is protecting the life of the patient.

.

Anesthesia risk notification

The story continues
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.

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.

.

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Later, I learned that the 79 -year-old woman who was about to undergo thoracoscopic lobectomy on the right under general anesthesia the next day , her husband was paralyzed at home because of cerebral infarction in the first three months, and her daughter died of kidney cancer
.

.

.

.

.

In the end, he waited until the son-in-law arrived, and completed the preoperative anesthesia evaluation signing process
.

From the perspective of the elderly: Many elderly people always take the attitude of reporting good news to their children, just like I don’t like this dress.
I’m not hungry.
If you eat more, parents’ love for us can be said to be selfless.
I don't even want to drag my children down because I am about to undergo surgery.
I firmly believe that I can handle it and survive it
.
However, it is ignored that surgical anesthesia is risky, and the consent and signature of his family or related persons should be obtained
.

From the perspective of anesthesia care: In outpatient clinics, we often see elderly people signing on their own.
First of all, in their opinion, they really hope to meet doctors and nurses with warmth.
We should be more patient, not unwilling to let you sign by yourself, but We must tell the patient that we want to contact your family members.
General anesthesia surgery is risky.
We should let the children know and let them lay down their work during the operation to accompany the elderly.
Whether it is an anesthesiologist or a surgeon, the operation must be done before the operation.
It is the right of the patient and the family to inform the patient and family members of the risks that may arise, and it is also our obligation
.

Children of the moment: Children of the moment are dedicated to their children, but they are indifferent to their parents.
They hope that the elderly are independent and independent.
The elderly do not say anything, but the psychological is that they want their children to be filial
.
When parents are sick and hospitalized and need to undergo surgery, they should give up time to accompany them.
This is the obligation of the children, and it is also an inescapable responsibility
.

Summarize:

Before a patient’s operation, whether it is an anesthesia signature or a surgical signature is an important part of the preoperative preparation.
The patient and family members should pay attention to it, prepare in advance and make time for the preoperative signature, regardless of the size of the operation.
Accidents may occur, and sometimes it is expected that a smooth operation may be difficult, and the signature of the operation can further explain the nature of the disease and the purpose of treatment to the family, preoperative preparation, anesthesia plan, intraoperative monitoring, postoperative recovery and analgesia.
This can not only relieve the patient's ideological pressure, but also better enable the patient to cooperate with the operation
.

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