Sunday, January 1, 2012

Tips from a Road Warrior (19): Abort a Landing if the Conditions are Unsafe!

Being part of an aborted plane landing is a strange experience. Everyone is ready, the wheels of the plane were out, the flight attendants are seated in their bulkhead seats, and suddenly you feel a very strong acceleration as the plane takes off again and flies straight over the runway, ready to circle around and try again. The first few seconds are somewhat worrisome till the captain comes over the speaker and announces the reason for the aborted landing. I recall one case where he noticed that there was a problem with timely clearing of the airstrip by another plane. I agree that in this case it is to be better safe than sorry and make sure that the next try is better prepared. 

A similar experience of an aborted procedure happened recently to the dad of one of my good friends. He was scheduled for back surgery, and ready to go. He was admitted, prepped with all the IV's and monitors already connected and surrounded with his family till the surgeon came in for a latest check of his files. He noticed that the patient had been taking a blood thinner each morning to take care of a heart condition, prescribed by his cardiologist. Fortunately, the surgeon noticed this and canceled the procedure right away as the patient might have bled to death during the procedure. Everyone went home and was told to come back in a week, after the patient being off the medication for a week. The good news is that this was caught just in time, the bad news is that resources were scheduled and everyone was ready to go. 

There is a lot of talk about implementing electronic health records and how universal access by every healthcare practitioner who can review preconditions, allergies, and definitely medications will provide a safer and more efficient healthcare delivery. Here was a good example that hit home very close to me. Our regional hospital is implementing an Electronic Health record right now. I am sure that the available incentives provided by the American Recovery Act to implement Health Records in a Meaningful Use manner has a lot to do with it. However, their first implementation is only to level 4 of the HIMSS US EMR adoption model (see http://www.himssanalytics.org) , which excludes closed loop medication administration, another essential component of electronic health records. The latter would prevent potential drug interactions, inappropriate dosages and drug-allergy interactions. In my opinion, implementing these solutions cannot go fast enough. Imagine the number of unfortunate events that would be prevented or lives saved if this would be available.

Like aborting a plane landing, aborting a medical procedure if it is not deemed safe is a good thing. It would have been better if one could have prevented the conditions causing the cancelation to start with so as not to potential create dangerous situations which could impact the live of one of more people. 

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