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psnet.ahrq.gov/node/846768/psn-pdf
March 29, 2023 - Endotracheal Tube Fallout in a Patient with Severe
Obesity During Eye Surgery.
March 29, 2023
Bohringer C. Endotracheal Tube Fallout in a Patient with Severe Obesity During Eye Surgery. PSNet
[internet]. 2023.
https://psnet.ahrq.gov/web-mm/endotracheal-tube-fallout-patient-severe-obesity-during-eye-surgery
The Ca…
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psnet.ahrq.gov/web-mm/delayed-diagnosis-endocrinologic-emergencies
November 13, 2024 - Related Resources From the Same Author(s)
Workplace violence pervasiveness in the perioperative
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psnet.ahrq.gov/web-mm/isolated-clot-real-error
December 01, 2013 - Perioperative bridging anticoagulation in patients with atrial fibrillation.
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psnet.ahrq.gov/node/49737/psn-pdf
June 01, 2015 - Perioperative use in selected surgical procedures.
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psnet.ahrq.gov/web-mm/missing-large-vessel-occlusion-stroke-patient-history-seizures
August 31, 2022 - Related Resources From the Same Author(s)
WebM&M Cases
Perioperative
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psnet.ahrq.gov/web-mm/pains-chronic-opioid-usage
April 04, 2018 - Director, Pain Management Center of Paducah, Paducah, Kentucky Clinical Professor, Anesthesiology and Perioperative
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psnet.ahrq.gov/node/33828/psn-pdf
March 01, 2017 - explaining-michigan-developing-ex-post-theory-quality-improvement-program
https://psnet.ahrq.gov/issue/how-strong-evidence-use-perioperative-beta-blockers-non-cardiac-surgery-systematic-review-and
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psnet.ahrq.gov/sites/default/files/2023-06/under_pressure.pdf
January 01, 2023 - Microsoft PowerPoint - FINAL Spotlight Case_Under Pressure.pptx
Spotlight
Under Pressure: Tracheostomy Cuff Over Inflation
Leading to Tissue Necrosis and Cuff Rupture
Source and Credits
• This presentation is based on the June 2023 AHRQ WebM&M
Spotlight Case
o See the full article at https://psnet.ahrq.gov/webmm…
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psnet.ahrq.gov/node/837660/psn-pdf
July 08, 2022 - An Incomplete Anesthesia History Leads to Adverse
Outcomes
July 8, 2022
Bohringer C. An Incomplete Anesthesia History Leads to Adverse Outcomes. PSNet [internet]. 2022.
https://psnet.ahrq.gov/web-mm/incomplete-anesthesia-history-leads-adverse-outcomes
The Cases
Case 1: A 64-year-old man came in for a routine bron…
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psnet.ahrq.gov/web-mm/hidden-heparins-hit-happens
March 27, 2024 - Interface
September 28, 2022
The impact of hindsight bias on the diagnosis of perioperative
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psnet.ahrq.gov/node/865466/psn-pdf
March 27, 2024 - racial-ethnic-and-payer-disparities-adverse-safety-events-are-there-differences-across
indicators (e.g., postoperative sepsis infections, perioperative
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psnet.ahrq.gov/sites/default/files/2024-07/spotlight_case_intraoperative_awareness_during_rhinoplasty_slides_final.pptx
January 01, 2024 - Effect of perioperative benzodiazepine use on intraoperative awareness and postoperative delirium: a
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psnet.ahrq.gov/web-mm/unseen-perils-urinary-catheters
January 31, 2024 - Perioperative use in selected surgical procedures.
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psnet.ahrq.gov/web-mm/hypoxic-gas-supply-cross-connected-pipelines
February 05, 2020 - 2019
View More
Related Resources
Perspectives on anesthesia and perioperative
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psnet.ahrq.gov/perspective/equity-patient-safety
September 24, 2024 - However, on some indicators (e.g., postoperative sepsis infections, perioperative hemorrhage), these
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psnet.ahrq.gov/web-mm/what-happened-telemetry
January 18, 2012 - November 16, 2022
WebM&M Cases
Perioperative Anaphylaxis
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psnet.ahrq.gov/web-mm/hurried-team-huddle-and-poor-communication-unsafe-practice-during-anesthesia-emergency
September 27, 2023 - August 30, 2023
Perioperative patient safety recommendations: systematic review
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psnet.ahrq.gov/node/849679/psn-pdf
June 28, 2023 - Under Pressure: Tracheostomy Cuff Over Inflation
Leading to Tissue Necrosis and Cuff Rupture
June 28, 2023
Gould E, Carlsen K, Trask J, et al. Under Pressure: Tracheostomy Cuff Over Inflation Leading to Tissue
Necrosis and Cuff Rupture. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/under-pressure-tracheost…
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psnet.ahrq.gov/web-mm/incomplete-anesthesia-history-leads-adverse-outcomes
January 29, 2021 - An Incomplete Anesthesia History Leads to Adverse Outcomes
Citation Text:
Bohringer C. An Incomplete Anesthesia History Leads to Adverse Outcomes. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
Copy Citation
Format:
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psnet.ahrq.gov/web-mm/case-mistaken-capacity-why-thorough-psychosocial-history-can-improve-care
July 08, 2022 - July 28, 2021
Just culture: the foundation of staff safety in the perioperative