How do physicians learn to respond to unfamiliar, unusual situations? Medical textbooks are full of helpful information, but they usually do not address complex clinical scenarios. For anesthesiologists, problems are often encountered in the operating room where textbooks and medical journals are not readily available. Even when a text is handy, practical decisions often must be made immediately. Residents in training, recent graduates, and even the most senior anesthesiologists, learn by experience. Case c- ferences and grand rounds are held in almost every hospital so that all staff members can share in their colleague’s experiences. In this book, a c- panion to Near Misses in Pediatric Anesthesia, which was originally p- lished in 1999, John G. Brock-Utne pre sents a variety of interesting cases. Dr. Brock-Utne has a unique talent for describing real clinical dilemmas and their solutions in a concise, interesting, and entertaining manner. I have known the author for more than 30 years, and his enthusiasm for teaching our residents and medical students, combined with his outstanding abilities as a clinical anesthesiologist, are legendary at Stanford Medical Center. Those same qualities are evident in this book. I believe every reader, from the novice anesthesiologist to the most senior clinician, will bene? t from the “experiences” Dr. Brock-Utne brings to this book.

No Fiberoptic Intubation System: A Potential Problem.- Is the Patient Extubated?.- A Strange Computerized Electrocardiogram Interpretation.- Fractured Neck of Femur in an Elderly Patient.- Spinal Anesthetic That Wears Off Before Surgery Ends.- Just a Simple Monitored Anesthesia Care Case.- Smell of Burning in the Operating Room.- Inguinal Hernia Repair in a Diabetic Patient.- The Case of the “Hidden” IV.- Postoperative Painful Eye.- Awake Craniotomy with Language Mapping.- Gum Elastic Bougie: Tips for Its Use.- External Vaporizer Leak During Anesthesia.- Manual Ventilation by a Single Operator: With Patient Turned 180 Degrees Away from the Anesthesia Machine.- Life-Threatening Arrhythmia in an Infant.- Tongue Ring: Anesthetic Risks and Potential Complications.- Hasty C-Arm Positioning: A Recipe for Disaster.- Inability to Remove a Nasogastric Tube.- An Unusual Cause of Difficult Tracheal Intubation.- Pulmonary Edema After Abdominal Laparoscopy.- Difficult Laryngeal Mask Airway Placement: A Possible Solution.- Postoperative Airway Complication After Sinus Surgery.- An Unusual Capnograph Tracing.- A Respiratory Dilemma During a Transjugular Intrahepatic Portosystemic Shunt Procedure.- A Tracheostomy Is Urgently Needed, but You Have Never Done One.- General Anesthesia for a Patient with a Difficult Airway and a Full Stomach.- Jehovah’s Witness and a Potentially Bloody Operation.- Intraoperative Insufflation of the Stomach.- Sudden Intraoperative Hypotension.- Overestimation of Blood Pressure from an Arterial Pressure Line.- Severe Decrease in Lung Compliance During a Code Blue.- Shortening Postanesthesia Recovery Time After an Epidural: Is It Possible?.- Difficult Airway in an Underequipped Setting.- Delayed Cutaneous Fluid Leak After Removal of an EpiduralCatheter.- Traumatic Hemothorax and Same-Side Central Venous Access.- Single Abdominal Knife Wound? Easy Case?.- A Draw-Over Vaporizer with a Nonrebreathing Circuit.- Unexpected Intraoperative “Oozing”.- Central Venous Access and the Obese Patient.- Taking Over for a Colleague: Always a Potential Concern.- Intraoperative Epidural Catheter Malfunction.- Breathing Difficulties After an Electroconvulsive Therapy.- White “Clumps” in the Blood Sample from an Arterial Line: Are You Concerned?.- Anesthesia for a Surgeon Who Has Previously Lost His Privileges.- Airway Obstruction in a Prone Patient.- A Question You Should Always Ask.- Postoperative Vocal Cord Paralysis.- A Serious Problem.- A Leaking Endotracheal Tube in a Prone Patient.- Lessons from the Field: Unusual Problems Require Unusual Solutions in Impossible Situations.- An “Old Trick” but a Potential Problem.- A Loud “Pop” Intraoperatively and Now You Cannot Ventilate.- Postoperative Median Nerve Injury.- A Patient in a Halo: Watch Out.- Now or Never: Developing Professional Judgment.- General Anesthesia in a Patient with Chronic Amphetamine Use.- What Is Wrong with This Picture?.- The One-Eyed Patient.- A Near Tragedy.- Robot-Assisted Surgery: A Word of Caution.- An Airway Emergency in an Out of Hospital Surgical Office.- Bonus Question: Is the Patient Paralyzed?.

How do physicians learn to respond to unfamiliar, unusual situations? Medical textbooks are full of helpful information, but they usually do not address complex clinical scenarios. For anesthesiologists, problems are often encountered in the operating room where textbooks and medical journals are not readily available. Even when a text is handy, practical decisions often must be made immediately. Residents in training, recent graduates, and even the most senior anesthesiologists, learn by experience. Case c- ferences and grand rounds are held in almost every hospital so that all staff members can share in their colleague’s experiences. In this book, a c- panion to Near Misses in Pediatric Anesthesia, which was originally p- lished in 1999, John G. Brock-Utne pre sents a variety of interesting cases. Dr. Brock-Utne has a unique talent for describing real clinical dilemmas and their solutions in a concise, interesting, and entertaining manner. I have known the author for more than 30 years, and his enthusiasm for teaching our residents and medical students, combined with his outstanding abilities as a clinical anesthesiologist, are legendary at Stanford Medical Center. Those same qualities are evident in this book. I believe every reader, from the novice anesthesiologist to the most senior clinician, will bene? t from the “experiences” Dr. Brock-Utne brings to this book.