patient DIED yesterday at MVP.... warnnnnnnnning

[sheonlylooks25]

jphuoc said: ↑

I know this was directed to MissOrange, but I thought I would give some input. My biggest advice? Be honest. Notify the clinic of any preexisting health conditions and all medications you are taking, including herbal supplements. In the US, young, healthy adults generally do not undergo extensive workups prior to outpatient surgery. Even an ECG is usually not obtained for a 20-something year old with no significant medical history.

Here's some questions that a standard evaluation should include:

Do you have any drug allergies? Have you had GA before? Have you or any family members ever experienced problems with GA, such as fever or death? Do you have a history of seizures or stroke? Any lung conditions, such as asthma or shortness of breath? Do you smoke? Do you drink? Any recreational drug use? Any cardiac conditions such as high blood pressure or an abnormal heart rhythm? Are you able to climb at least 2 flights of stairs without stopping? Any stomach issues, such as acid reflux when you lay flat? Thyroid problems? Diabetes? Have you noticed any easy bleeding or bruising?

Just some questions to think about.

And PLEASE, for the love of God, no food 8 hours prior to surgery, no water 2 hours prior to surgery.

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I thought it was 12 hours of no food and water to avoid any possibility of regurgitation while you are under GA. That's the standard for Australia.

 

[elijahspk]

Amali9099 said: ↑

I am only jumping in just to say that panic doesn't usually involve fixing one's hair and that a trained doctor or nurse should be well past the point of any kind of meltdown. In other countries, medical students are subjected to enough emergencies that by the time they graduate, they are trained to react adequately.

My guess is the anger is coming from the lackadaisical manner in which the staff conducted themselves while a kid's life slipped away on the table. It is a horrifying thing to envision and the anger is augmented when one wonders, heart issue or not, if his life would have been saved had he received proper emergency treatment. Today, it was him. Tomorrow it is you, me, or anyone else here.

While I do think this case (and others like it) should engender change in the forms of better policies, procedures, and even laws requiring better emergent care, the conduct here suggests something more than "poor training" and points a bit more to negligence. So I can understand those who are calling for criminal charges.

If a clinic can't manage itself during an emergency during which a patient's life hangs in the balance, then they shouldn't be taking patients' money and offering to do surgery.

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Exactly my point

 

[amali9099]

jphuoc said: ↑

All septoplasties and rhinoplasties should be done under GA for the reason you mentioned. However, an LMA is not considered a protected airway. If there is an increased risk for aspiration, an endotracheal tube should be used.



In the US, coagulation panels are not routinely sent for outpatient procedures.



Truth.

Extensive lab work and physical evaluations are not performed on young patients with no prior medical history even at the most renowned medical centers. This unfortunate incident should highlight the risks we all are accepting when having procedures done at an outpatient center. Outpatient centers are not equipped like major hospitals, and the staff are not as prepared to handle emergent events.

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@jphuoc
I was told that my tip/alar reduction (first-time) rhino could be done under sedation not GA by JK, a clinic that I am looking at.
Is that unsafe? Please let me know as I am flying to SK soon for consults.

 

[pear-orange]

MissOrange said: ↑

Have you had GA before @pear orange ? It is a hard question to answer. Rationally you should be fine with GA as having an unknown heart condition is very rare and if you have had GA before without any problems that should reassure you more. However there is a fear factor when a clinic has a death. I can't answer that question for you. I am a very anxious person so GA in korea terrifies me.

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I never had GA before, only local anesthesia. I think I would just voice my concerns to the clinic honestly and see what they say.

Thank you for your advice @MissOrange

 

[pear-orange]

jphuoc said: ↑

I know this was directed to MissOrange, but I thought I would give some input. My biggest advice? Be honest. Notify the clinic of any preexisting health conditions and all medications you are taking, including herbal supplements. In the US, young, healthy adults generally do not undergo extensive workups prior to outpatient surgery. Even an ECG is usually not obtained for a 20-something year old with no significant medical history.

Here's some questions that a standard evaluation should include:

Do you have any drug allergies? Have you had GA before? Have you or any family members ever experienced problems with GA, such as fever or death? Do you have a history of seizures or stroke? Any lung conditions, such as asthma or shortness of breath? Do you smoke? Do you drink? Any recreational drug use? Any cardiac conditions such as high blood pressure or an abnormal heart rhythm? Are you able to climb at least 2 flights of stairs without stopping? Any stomach issues, such as acid reflux when you lay flat? Thyroid problems? Diabetes? Have you noticed any easy bleeding or bruising?

Just some questions to think about.

And PLEASE, for the love of God, no food 8 hours prior to surgery, no water 2 hours prior to surgery.

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Thank you so much for all these tips. I’m going to forward all these important advice to my friends who wants to get PS in Korea

 

[hautelady]

OMG I just saw this. Poor lad and his family.
I am amazed at the flow of events. 911 or 119 took too long to arrive or was not called right away. I guess with the 1100 ps clinics relying on them for emergencies like this , they must be swamped.
The family being local, they were able to secure a lawyer within 24 hours. But still I am amazed how MVP is already declared innocent roughly after 48 hours. The autopsy and/or investigation are too quick like in the movies. I mean, you can’t ecg the dead patient for abnormalities so their pathology/forensic lab can turn around faster for a compete autopsy so fast. Cardiac arrest on young patients need not just a regular autopsy but a detailed neuropathological and cardio with toxicology autopsy.

So is it like “business as usual” for them? I mean, you gotta question the characters of these caregivers who you hand your life to. They may behave more professional from now on (Like act harried in front of cctv) but really the true characters of people show in knee-jerk/life threatening events.

I hate to imagine this happening to any foreigner like me, unaccompanied with love ones thousands of miles away. I’d probably just be a statistic.

 

[jphuoc]

SheOnlyLooks25 said: ↑

I thought it was 12 hours of no food and water to avoid any possibility of regurgitation while you are under GA. That's the standard for Australia.

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American Society of Anesthesiologists recommends at least 2 hours for water/clear liquids and 8 hours for meals, excluding patients with uncontrolled diabetes who have delayed gastric emptying. But I mean, of course play it safe and follow clinic recommendations. 12 hours without water is overkill in my opinion. Most anesthetics cause a decrease in blood pressure... and being severely dehydrated definitely does not help.

Amali9099 said: ↑

@jphuoc
I was told that my tip/alar reduction (first-time) rhino could be done under sedation not GA by JK, a clinic that I am looking at. Is that unsafe? Please let me know as I am flying to SK soon for consults.

Click to expand...

I am not familiar with anesthesia practice in South Korea. I have never seen a rhinoplasty performed under conscious sedation, but it depends on the depth of anesthesia used. If the surgeon relies primarily on injections of local anesthesia at the surgical site, and you are kept relatively awake, there will be a lower risk of aspirating blood or stomach contents into your lungs since your body is “awake enough” to protect itself. However, the greater the depth of anesthesia, the higher the risk of aspiration without an endotracheal tube secured in your airway.

 

[lemontea1234]

ElijahSpk said: ↑

I agree with everything you said except the "panic" issue. As far as my knowledge goes, doctors and nurses are all well trained to handle medical emergencies without getting panicked. So there's no question of them getting panicky in such unforeseen circumstances.

No f**king training and experience can teach any doctor or nurse to not laugh, engross oneself in making ponytails and crossing arms when a patient is dying. You know why, right? Because this is a serious character flaw(as stated by MissOrange) and that too shockingly coming from a doctor and nurses at whom people trust completely & have faith in them for their lives.

There would have been completely no issues at all only if for the doctor and nurses extreme efforts to save that dying soul, but, very shockingly the scenario in this tragic incident was just completely opposite and actually very heartbreaking and gut-wrenching.

The problem is not the boy's "unknown heart condition" but the attitude of those nurses and, of course, the doctor who did literally NOTHING to save that dying soul. I don't seem to understand that how can you attribute this bizarre behavior with training and experience???

P.S: Don't you think that it's a bit rude to judge anybody's age from their opinion?

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I'm saying its just a possibility. Its like if you never come across something, most peoples reaction would be scared or wary right? So if a clinic doesnt train their staff to be well versed in emergency, their reaction can be one of panic. I'm not excusing their behaviour, but suggesting a possible reason why they behaved that way. Some people when they get nervous or panicky, they laugh. Its just a personality trait that some people have.

Like missorange said, some of them are nurses assistants not even RN. Therefore some of them may not even be hospital trained. Therefore, they may not have been exposed to medical emergencies and do not know to conduct themselves. I dont know the standard of training in korea compared to here. But even here as registered nurses, we run through sim scenerios every 2nd week, so we know how to deal with different situations.

Hence why I stated, if they were well trained and KNOW what to do in emergencies. Then this would have been a different story.

Thats just my point of view. Take it as such.

 

[lemontea1234]

MissOrange said: ↑

Wow @lemontea1234 that is amazing to read you run through simulated scenarios every 2nd week!

This is an excerpt on how to reduce deaths from GA, "But despite all precautionary measures, there are risks to general anesthesia. “In emergencies, the whole team has to function right automatically because there’s no time to think,” says Gottschalk. “For that to happen, I recommend regular simulations with the whole team, so that communication works when there’s a real emergency.”

The problem is the stats on death from GA are 7 per 100,000 so I can see why korean plastic surgery clinics may not run simulations of what to do for cardiac arrest let alone own a defibrillator.

I guess now we should include in our kakao chat with clinics the question do you have a defibrillator and what is your serious anaesthetic complication or death rate? Maybe even ask to see the defibrillator at consultation? But it seems extreme for patients to have to be checking. Here we have cqc inspectors who do clinic site visits with their clipboards.

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Haha. We do. We have 200 staff in our unit. So do sims on a bi weekly basis. So by end of the quarter at least most if not all has experiences in an sim environment. And we take it in turns. We grumble about them. But see the benefit of it. It really helps to see what needs to be improved on so its a good thing.

 

[arnott]

MissOrange said: ↑

Another pfer referenced an article citing that most korean plastic surgery clinics do not have a defibrillator on site! I hope they buy a defibrillator now that this has happened @SheOnlyLooks25. Yes you would think korean surgical clinics should all stock a defibrillator as it reads the rhythm and even tells you when to shock and any layperson can use! Hoping this case brings about change for the better.

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I find this so surprising as even my local community centre has one!

 

[fortunecat]

arnott said: ↑

I find this so surprising as even my local community centre has one!

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In Singapore, we have AEDs in public places like shopping malls, train stations etc.

 

[fortunecat]

When i enquired about liposuctions in Singapore, one plastic surgeon informed me that the anaesthetist's fee is S$800/hour.

 

[lil_tige7]

frangranceaddict said: ↑

WARNNNNNNNNNNNNNNNNNNNINGGGGGGGGGGG

a patient just died at MVP... just for rhinoplasty!!!!!!!!


what the ****?????????

https://m.news.naver.com/read.nhn?mode=LSD&mid=sec&sid1=102&oid=437&aid=0000191331

this is the article

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So scary. They don't care about safety. Money is important.