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In addition to monitoring the patient’s EEG level of consciousness (via a BIS monitor device called NeuroSENSE), this new device monitors traditional vital signs such as bloodoxygenlevels, heart rate, respiratory rate, and blood pressure, to determine how much anesthesia to deliver.
But when surgery or anesthesia leads to an acute event at a site distant from a hospital, the anesthesiologist involved in that patient’s care is responsible for that patient’s safety and for the ongoing care and resuscitation.
In addition to the BIS monitor, the iControl-RP monitored the vital signs of bloodoxygenlevel, heart rate, respiratory rate, and blood pressure to determine how much anesthesia to deliver.
The SOFA respiratory score is based on the ratio of: your bloodoxygenlevel (PaO2) divided by the percentage of oxygen that you’re breathing. Right now your bloodoxygenlevel is approximately 90 mm Hg, and the percentage of oxygen in room air that you are breathing is 21%, or 0.21
He was receiving propofol without an anesthesia professional to monitor his airway, breathing, and oxygen saturation. Untreated total airway obstruction can lead to plummeting bloodoxygenlevels in minutes. Irreversible hypoxic brain damage can occur if there is a lack of oxygen to the brain for as little as 5 minutes.
If this airway obstruction is not remedied, the oxygen saturation will drop below a safe level of 90%. At these low bloodoxygenlevels, the brain and heart will be deprived of necessary oxygen. A prolonged low bloodoxygenlevel can lead to life threatening cardiac dysrhythmias or a cardiac arrest.
The bloodoxygenlevel dropped acutely to life-threatening levels. The anesthesiologist then performed an emergency reintubation to replace the ET tube to again ventilate oxygen into the patient’s lungs to save his life.
Some brain cells start dying within five minutes after the oxygen supply disappears, and brain hypoxia can rapidly cause severe brain damage or death. 1,2) In malpractice cases I’ve consulted on, a five-minute window is an accepted duration for low bloodoxygenlevels to cause permanent brain damage.
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