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psnet.ahrq.gov/web-mm/cvc-placement-speak-now-or-do-not-use-line
November 01, 2003 - routinely placed each year for infusion, phlebotomy, and/or hemodynamic monitoring.( 1 ) Although overall complication … rates for CVC insertion should be exceedingly low, published complication rates vary considerably and … Failure and complication rates by three percutaneous approaches. … Complication Frequency Internal Jugular (%) Subclavian (%) Femoral (%) Arterial
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psnet.ahrq.gov/web-mm/dont-bite-your-tongue
September 18, 2024 - Background
Oropharyngeal injuries are a known complication of airway management during procedures … monitoring may minimize the risk of paralysis, which is a catastrophic and potentially preventable complication … A rare complication of tracheal intubation: tongue perforation.
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psnet.ahrq.gov/node/34640/psn-pdf
March 02, 2011 - complications during a given hospitalization
and found that nearly 20% of patients experienced a medical complication
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psnet.ahrq.gov/node/49464/psn-pdf
December 27, 2020 - After
accessing the abdomen with the trocar without complication, the surgeon inserted the laparoscope … Patient burns, though less common, are
clearly a morbid complication, accounting for about 5% of laparoscopic … burn injuries result from stray electrosurgical current released inside the abdomen, the less
common complication
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psnet.ahrq.gov/node/60533/psn-pdf
May 27, 2020 - This
article discusses a surgical complication incident that illustrates the importance of transparency
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psnet.ahrq.gov/sites/default/files/2023-01/spotlight_respiratory_distress_after_neck_surgery_two_cases_of_postoperative_cervical_hematoma.pdf
January 01, 2023 - SURGERY: TWO CASES OF POSTOPERATIVE
CERVICAL HEMATOMA
Two cases highlighting the rare but dangerous complication … Kuhn, MD, MAS
9
BACKGROUND
10
Background (1)
• These cases describe the rare but dangerous complication … • To successfully manage this life-threatening complication, appropriate
patient, caregiver and clinical … Points (1)
25
• Postoperative hematoma causing airway collapse is a rare but
potentially lethal complication … after anterior cervical spine surgery: analysis of the results of risk factors associated with airway
complication
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psnet.ahrq.gov/node/865929/psn-pdf
May 22, 2024 - diagnostic-stewardship-improve-patient-outcomes-and-healthcare-associated-
infection-hai
Healthcare-associated infections (HAIs) remain a common complication
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psnet.ahrq.gov/web-mm/intraosseous-line-extravasation-pediatric-trauma-patient
September 29, 2021 - significant morbidity can occur if the catheter is not inserted correctly or not removed promptly once a complication … of extravasation inherent to IO lines, it is critical that clinicians and care teams anticipate this complication … Compartment syndrome is a rare but serious complication associated with IO lines. … Intraosseous extravasation complication reports. … Case report of a complication. J Bone Jt Surg . 1993;75(3):428–9. [ Available at ]
Spivey WH.
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psnet.ahrq.gov/node/843736/psn-pdf
February 01, 2023 - Serious complications related to obstetric anesthesia: the
serious complication repository project of
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psnet.ahrq.gov/node/48188/psn-pdf
August 14, 2019 - analysis-human-performance-deficiencies-associated-surgical-adverse-events
https://psnet.ahrq.gov/issue/surgical-skill-and-complication-rates-after-bariatric-surgery
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psnet.ahrq.gov/node/46611/psn-pdf
January 01, 2021 - sustaining-teamwork-behaviors-through-reinforcement-teamstepps-principles
Poor teamwork in operating rooms is associated with higher postoperative complication
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psnet.ahrq.gov/node/846171/psn-pdf
July 26, 2022 - awakenings, and encouraging mobility.16-19
Approaches to Improving Patient Safety
Beyond the direct complication … The underlying
cause was a serious complication of a relatively simple procedure that is commonly performed … The
impact of the complication was compounded by lapses in communication between nursing staff and other … A case report of esophageal perforation: Complication of nasogastric
tube placement.
-
psnet.ahrq.gov/node/49677/psn-pdf
February 01, 2013 - routinely placed each year for infusion, phlebotomy, and/or
hemodynamic monitoring.(1) Although overall complication … rates for CVC insertion should be exceedingly
low, published complication rates vary considerably and … Failure and
complication rates by three percutaneous approaches. … Complication Frequency
Internal Jugular (%) Subclavian (%) Femoral (%)
http://www.ncbi.nlm.nih.gov
-
psnet.ahrq.gov/node/854992/psn-pdf
November 01, 2023 - metrics measure the ability of healthcare teams and hospitals to prevent
mortality following a major complication
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psnet.ahrq.gov/web-mm/agitated-delirium-contributes-missed-testing-and-delayed-diagnosis-gastric-perforation
June 28, 2023 - awakenings, and encouraging mobility. 16-19
Approaches to Improving Patient Safety
Beyond the direct complication … The underlying cause was a serious complication of a relatively simple procedure that is commonly performed … The impact of the complication was compounded by lapses in communication between nursing staff and other … A case report of esophageal perforation: Complication of nasogastric tube placement.
-
psnet.ahrq.gov/node/33664/psn-pdf
March 01, 2008 - You end up providing better
patient care and having lower complication rates. … But
when you look at the scant data in the literature in terms of complication rates for the various … Comparing that to our data, we've demonstrated a lower complication rate. … If an institution has a baseline complication rate for procedures and then a group wants to
start a … At our institution at this point, the
commitment goes beyond complication rates in the strict sense.
-
psnet.ahrq.gov/web-mm/bowel-injury-after-laparoscopic-surgery
January 19, 2016 - However, a surgeon encountering this complication and lacking in experience in laparoscopic suturing … Bowel injury as a complication of laparoscopy. Br J Surg. 2004;91:1253-1258. [go to PubMed] 2.
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psnet.ahrq.gov/node/836976/psn-pdf
April 27, 2022 - significant morbidity can occur if the catheter
is not inserted correctly or not removed promptly once a complication … extravasation inherent to IO lines, it is critical that clinicians and care teams
anticipate this complication … Compartment syndrome is a rare but serious complication associated with IO lines. … Intraosseous extravasation complication
reports.Ann Emerg Med. 1994;23(2):363-366. … Case report of a complication. J Bone Jt Surg.
1993;75(3):428–9. [Available at]
33. Spivey WH.
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psnet.ahrq.gov/web-mm/ventricular-wall-injury-during-diagnostic-cardiac-catheterization
September 01, 2012 - myocardial infarction, and stroke were even less, generally well below 1%. 2,3 One often-discussed complication … perforation is exceedingly rare, with only case reports published. 10,11 Unfortunately, in this case, the complication … Had this complication been recognized when the patient was still on the catheterization table, a right … Any discussion of a catastrophic complication of this type is incomplete without exploring how communication … dissection/perforation or left ventricular (LV) perforation is a rare but potentially catastrophic complication
-
psnet.ahrq.gov/node/74053/psn-pdf
November 10, 2021 - prevention-failure-rescue-obstetric-patients-realist-review
Failure to rescue, the delayed or missed recognition of a potentially fatal complication