hit tracker


Doctor discovers airline pilots reduced accidents by always ticking off a list of procedures before take off. He believed that surgical errors could be reduced the same way.

How To Prevent The Wrong Leg Being Amputated

Author
- Dr. Gifford Jones  Sunday, August 23, 2009
| Print friendly | Email Us

Are you scheduled for surgery in 2010? If so, you should know that agreeing to an operation involves some risk. This is a fact of life, and there may never be a way to reduce the risk to zero. But a study from The Harvard Medical School shows there’s a proven way to cut deaths following surgery by 40 percent.

Dr. Atul Gawande, Associate Professor of Surgery at Brigham and Women’s Hospital, in Boston, recently reported this interesting research in The New England Journal of Medicine.

 
Dr. Gawande analyzed surgical complications and death rates after surgery in hospitals in the U.S, Canada, England, New Zealand, Jordan, India, Tanzania and the Philippines. This was part of the World Organization Safe Surgery Saves Lives campaign.

 
So how can this study save lives? Dr. Gawande discovered that airline pilots reduced accidents by always ticking off a list of procedures to be completed before take off. He believed that surgical errors could be reduced the same way.
 

On his two-minute checklist, the first item is to confirm the patient’s identity. Then surgeons are sure they’re operating on the right patient. Next, what type of operation is being done, and where the incision will be made to avoid operating on the wrong breast or amputating the wrong leg.
 

The list also includes the best antibiotic if it’s needed, and what is the best anesthetic for each type of surgery. Lastly, what is the task of each member of the surgical team?

 
This pilot-inspired approach decreased complications and death by one-third in eight hospitals around the world. Overall, complications decreased from 11.0 percent to 7.0 percent and hospital deaths by an amazing 40 percent.

 
Today 234 million operations are done every year worldwide. If this checklist were employed in all countries it would save hundreds of thousands of lives.
 

Dr. Alex Haynes, another researcher associated with this study, said this checklist would also save 25 billion in complication related expenses annually in the U.S.

 
Harvard’s Brigham and Women’s Hospital is one of the great hospitals of the world and I trained there many year ago. But even this hospital is not immune to errors. Dr. Gawande relates how this checklist saved the life of one patient by reminding the surgeon to have enough blood ready for a transfusion.

 
Dr. Gawande reports that several countries and many U.S states are now committed to using the surgical checklist in the operating room. All we have to do is look at past surgical records to realize that adding a pilot’s checklist makes good sense.

 
For instance, The Canadian Medical Protective Association (CMPA) says that in spite of a decade of preaching preventive measures to avoid wrong-side surgery, about 10 cases occur every year in Canada. I couldn’t obtain U.S. figures but I’d bet it’s about 150 in that country.
 

In Canada during the period from 1995 to 2005 wrong-side surgery happened 106 times. Each year 6.3 cases involved a lower extremity and 4.3 the upper limb. The most common error was carrying out arthroscopy (looking into the joint with an optical instrument) on the wrong joint. This misfortune happened to 24 patients.


CMPA reports at least one case of total knee replacement was performed on the wrong knee. Hand and foot cases usually involved the wrong hand or an incorrect toe.

 
Many readers might wonder how, in the name of heaven, such errors could happen. They primarily result from a failure of common sense. In some instances the patient was anesthetized, the extremity prepared and draped for surgery before the patient was even seen by the surgeon.

 
In other instances the extremity that supposedly required surgery was marked by someone other than the operating surgeon. Or medical records or X-rays were not available in the operating room. In effect, hospital policy was rarely followed, or not at all.

 
I reported a few years ago that some hospitals have initiated a “time-out” before the incision is made to determine that all I’s have been dotted and T’s crossed. But a checklist makes more sense.

 
My advice to patients to prevent wrongful amputation is simple. Make the surgeon place his initial on the right extremity while you’re still awake.

 
If you know of any wrong-side surgeries, let me know.
     

Scroll down this page for Disqus Comments |

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker’s website is: docgiff.com.

Dr. Walker can be reached at: .(JavaScript must be enabled to view this email address).

.






Most Shared CFP stories



What's New On CFP:

  1. Latest American News
    By News on the Net -- --News Headlines
  2. Michelle Obama causes backlash by foregoing a headscarf while in Saudi Arabia - well done
    By Robert Laurie -- --American Politics
  3. Government TV mocks bid to repeal government health care
    By Dan Calabrese -- --American Politics
  4. Refreshing Honesty from James Hansen on Climate Policies
    By Institute for Energy Research -- --Global Warming-Energy-Environment
  5. Nova Scotia Supreme Court Sends Strong Message To Law Societies Refusing To Recognize Christian Law
    By News on the Net -- --Canada
  6. Latest News On ISIS and Radical Islam
    By News on the Net -- --News Headlines
  7. Sgt. Bowe Bergdahl
    By Dag Barkley -- --Cartoons
  8. Indiana’s Mike Pence Latest Republican Governor to Expand Medicaid
    By Heritage Foundation -- --American Healthcare
  9. Latest World News
    By News on the Net -- --News Headlines
  10. Here we go: Scott Walker’s committee releases first campaign ad - takes a shot at retread candidates
    By Robert Laurie -- --American Politics
  11. Beer compound could help fend off Alzheimer’s and Parkinson’s diseases
    By American Chemical Society -- --Medical News
  12. Casa de Campo Invites Vacationers to Book Early and Save with Limited-Time “Always Summer in C
    By News on the Net -- --Vacation Resorts, Travel
  13. Detecting chemical weapons with a color-changing film
    By American Chemical Society -- --Science-Technology
  14. U.S. Settles Suit Over Misuse of West L.A. Veterans Campus
    By Robert L. Rosebrock -- --American Life, History, Education
  15. The Doomsday Clock
    By Dr. Klaus L.E. Kaiser -- --Global Warming-Energy-Environment
  16. World’s smallest, cheapest patch pump for diabetics
    By Guest Column -- --Medical News
  17. More wind power will increase hydro rates
    By Guest Column -- --Global Warming-Energy-Environment
  18. Islam and Terrorism: A Futile Debate
    By INSS -- --World News
  19. Terrorists
    By William Bedford -- --Letter
  20. Your 529 Plan Is Safe. Here’s Why the White House Changed Course
    By Heritage Foundation -- --American Politics
  21. Eyeglasses that turn into sunglasses — at your command
    By American Chemical Society -- --Science-Technology
  22. The Michelle Obama Valerie Jarrett Publicity Hound Tag Team
    By Judi McLeod -- --Cover Story
  23. An Auschwitz Anniversary
    By Alan Caruba -- --Cover Story
  24. Refineries challenge EPA plan to cut emissions
    By American Chemical Society -- --Global Warming-Energy-Environment
  25. Wynne Is Promising More Debt, Not Less
    By Canadian Taxpayers Federation -- --Canada
  26. Lies And Deception In Ukraine’s Energy Sector
    By Oilprice.com -- --Global Warming-Energy-Environment
  27. Obama’s Economic Shell Game
    By Guest Column -- --American Politics
  28. The Northeast Nanny-staters Who are and the Blizzard that Never Was
    By Selwyn Duke -- --American Politics
  29. Film narrator: Obama’s missed calling
    By A. Dru Kristenev -- --Cover Story
  30. Obama’s Proposed Capital Gains Rate Hikes Will Hurt the Economy
    By Alan Joel -- --Cover Story







Caruba: Professional Writing Services



Pursuant to Title 17 U.S.C. 107, other copyrighted work is provided for educational purposes, research, critical comment, or debate without profit or payment. If you wish to use copyrighted material from this site for your own purposes beyond the 'fair use' exception, you must obtain permission from the copyright owner.

Views are those of authors and not necessarily those of Canada Free Press. Content is Copyright 1997-2014 the individual authors.

Site Copyright 1997-2014 Canada Free Press.Com Privacy Statement


Powered by ExpressionEngine

{/exp:ce_cache:it}