Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · May 2009
Case Reports[Difficulty of regional anaesthesia catheter withdrawing due to a knot: three case reports].
We observed three cases of knots after peripheral nerve catheterism. Catheter removal was impossible and required the intervention of an anaesthetist. ⋯ The catheter removal should be included in a protocol. One solution might be the use of a network to meet all the complications that happen in continuous peripheral nerve blocks, particularly at home.
-
Ann Fr Anesth Reanim · May 2009
[Accidental intravenous injection of potassium chloride: analysis of contributing factors and barriers to risk reduction].
Errors linked to injectable potassium chloride (KCl) have been the cause of deaths which have occurred for many years. Following an accidental direct intravenous injection of KCl of no clinical consequence for the patient, we have analyzed the contributive factors, established an action plan to prevent this risk and finally assessed its impact. Among the causes leading to medication errors, we have identified those linked to the handling of the drugs by nurses, the team, the work conditions, the organization, the institutional context and finally to the drug itself. ⋯ The drug supply chain of our institution, as in numerous others, is not safe. Hospitals are not yet organized adequately to prevent the occurrence of such an error. The comparison with foreign organizations of drug dispensation allows us to think that the improvement and professionalization of the drug supply chain will both be assets in the prevention of such medication errors.