Atul Gawande, MD, a surgeon at Boston-based Brigham and Women's Hospital and writer for The New Yorker, claims physicians should incorporate a simple checklist into their pre-surgery routine because it may mean the difference between life and death for the patient.
In an interview with WPSU Penn State, Dr. Gawande recounted conducting a procedure years ago in which things took a significant turn for the worse mid-surgery.
Dr. Gawande said the procedure involved removing a tumor from the adrenal gland of patient he refers to as Mr. Hagerman. The tumor was behind Mr. Hagerman's liver, next to the vena cava blood vessel. Dr. Gawande said he managed to successfully remove the tumor, but accidently nicked the blood vessel.
"I ended up creating a hole in the vena cava, which meant that [Mr. Hagerman] then pretty quickly lost his entire blood volume into his abdomen. … He lost basically ten times his body volume in blood. But we were able to give him enough blood to keep his circulation going," Dr. Gawande said. "We were finally able to repair the hole in the vena cava, get the tumor out, and have him recover."
While the successful outcome could be chalked up to Dr. Gawande's skill as a surgeon, he told WPSU Penn State that was far from the case. He said what saved the patient's life was the checklist the surgical team made prior to the operation to note any unexpected issues and take the necessary precautions should the worst-case scenario occur.
"When we ran the checklist, when we got to the part where we said, 'What's the goal of the operation and tell me anything unexpected about this,' I mentioned to the anesthesiologist that this tumor was pretty tightly against the vena cava. The anesthesiologist then prepared to get more blood into the room, just in case," said Dr. Gawande.
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