Amputating the wrong limb
Discussion
It seems to me that - outside of emergencies - it should be really easy to amputate the correct limb. All you do is paint the other one (or in the case of fingers, ones) red and you paint the one you want to amputate green. Is there some reason they don't do this or something like it? Or if they do do this or something like it, how on earth do they chop the wrong one off so often?
Somewhatfoolish said:
It seems to me that - outside of emergencies - it should be really easy to amputate the correct limb. All you do is paint the other one (or in the case of fingers, ones) red and you paint the one you want to amputate green. Is there some reason they don't do this or something like it? Or if they do do this or something like it, how on earth do they chop the wrong one off so often?
They draw big arrows on the limb to be removed. What makes you think “they” are regularly getting this wrong?Alex Z said:
Somewhatfoolish said:
It seems to me that - outside of emergencies - it should be really easy to amputate the correct limb. All you do is paint the other one (or in the case of fingers, ones) red and you paint the one you want to amputate green. Is there some reason they don't do this or something like it? Or if they do do this or something like it, how on earth do they chop the wrong one off so often?
They draw big arrows on the limb to be removed. What makes you think they are regularly getting this wrong?Anyway why not also mark (in a completely different way) the one NOT to be removed? That seems like a very sensible extra precaution that would be dead easy.
I had my ankle pinned and plated recently after breaking every bone and ligament possible 
Despite being in a cast up to my knee, and my knee itself having a big arrow drawn on pointing down, I think on the day of the surgery I must've been asked 20 times which ankle they were doing the surgery on. They knew, of course, but it seemed sensible to double check at each point of contact.
I did answer "is it not obvious" a few times and they said it's just to check. The fact I was asked so often didn't stop me from immediately checking they'd done the correct one once I came round from the anesthesia though
Despite being in a cast up to my knee, and my knee itself having a big arrow drawn on pointing down, I think on the day of the surgery I must've been asked 20 times which ankle they were doing the surgery on. They knew, of course, but it seemed sensible to double check at each point of contact.
I did answer "is it not obvious" a few times and they said it's just to check. The fact I was asked so often didn't stop me from immediately checking they'd done the correct one once I came round from the anesthesia though
Somewhatfoolish said:
Just hear about it on the news occasionally. Would have thought it should be vanishingly rare.
Things that happen all the time don't generally get on the news.But something like this happening is tragic. I strongly suspect it's also very rare. Combine those and ta-da; it's newsworthy.
(not intended to sound callous towards whoever this has happened to!)
Somewhatfoolish said:
Just hear about it on the news occasionally. Would have thought it should be vanishingly rare. Or are there a lot more amputations than I think?
Anyway why not also mark (in a completely different way) the one NOT to be removed? That seems like a very sensible extra precaution that would be dead easy.
It adds potential for confusion (and issues for the colour blind...) while giving no benefit as the same mistake could be made and then reinforced by the new method.Anyway why not also mark (in a completely different way) the one NOT to be removed? That seems like a very sensible extra precaution that would be dead easy.
Wrong site surgery seems to have an incidence of about 1:100,000 cases. Some specialties are more at risk (eg hand surgery - there's often 10 options to choose from).
In a normal, non-rushed, well staffed operating list it's incredibly rare. We check and check and check again, especially with something like an amputation. We have numerous checklists to go through, patients are marked before they've had any drugs so they can tell us which bit they're expecting to get cut up.
I've heard all sorts of ideas re marking patients. In my opinion, marking one side as yes and one side as no is really risky; if the patient wishes their hands or gets changed, marks get smudged. One clear mark, put on by me, with patient cooperation, often with the name of the procedure written alongside is my preferred method.
As always, errors occur due to system factors and human factors. System factors are things like understaffing, list order changes, poor timing. Human factors are usually fatigue (often too many check points lead to people zoning out) and poor communication (eg list order changed, nobody told the surgeon).
Despite all this, mistakes happen. Planes crash. etc. If they didn't, we could all save a lot of money on insurance.
In a normal, non-rushed, well staffed operating list it's incredibly rare. We check and check and check again, especially with something like an amputation. We have numerous checklists to go through, patients are marked before they've had any drugs so they can tell us which bit they're expecting to get cut up.
I've heard all sorts of ideas re marking patients. In my opinion, marking one side as yes and one side as no is really risky; if the patient wishes their hands or gets changed, marks get smudged. One clear mark, put on by me, with patient cooperation, often with the name of the procedure written alongside is my preferred method.
As always, errors occur due to system factors and human factors. System factors are things like understaffing, list order changes, poor timing. Human factors are usually fatigue (often too many check points lead to people zoning out) and poor communication (eg list order changed, nobody told the surgeon).
Despite all this, mistakes happen. Planes crash. etc. If they didn't, we could all save a lot of money on insurance.
I remember a story some years ago about a guy going into surgery to have a diseased kidney removed and they unfortunately removed the healthy kidney.
he then died shortly after from kidney failure when he could have survived for years on the healthy kidney which had nothing wrong with it but they removed it.
he then died shortly after from kidney failure when he could have survived for years on the healthy kidney which had nothing wrong with it but they removed it.
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