Grainger ,helen finding 1767 08 2012 05 31 14 40 06 300

29y · Female·Hypoxic Encephalopathy consequent upon Cardiorespiratory Arrest arising from either an excessive intake of Adrenaline or Anaphylaxis, on a background of Cephalosporin Allergy

Helen Grainger, 29, with polycystic kidney disease and asthma, underwent pregnancy termination at Lambton Road Day Surgery in April 2007. She developed anaphylaxis post-procedure (likely cephalosporin-triggered) with cardiorespiratory arrest. The attending GP sedationist administered adrenaline but failed to intubate effectively, leaving her severely hypoxic for 15-20 minutes before paramedics arrived. She died of hypoxic encephalopathy. Key clinical failures: inadequate monitoring (no ECG, no blood pressure recording during crisis), lack of intubation expertise in the attending clinician (hadn't intubated since 1994), and inappropriate facility choice (day surgery versus tertiary hospital for complex patient). The case underscores critical lessons: non-anaesthetist sedationists must maintain emergency resuscitation skills and intubation competency; complex cases require appropriate facility selection; and continuous monitoring with ECG is essential when using adrenaline.