16 results for “oxygen desaturation”
47y · Male·Aspiration pneumonia due to or as a consequence of coronary atherosclerosis
… pneumonia with contributing coronary atherosclerosis following routine L5-S1 disc replacement. A critical oxygen desaturation (64%) occurred during transfer from theatre to PACU but was inadequately investigated—the ana…
79y · Female·aspiration pneumonia caused by aspiration of emesis secondary to small bowel obs…
…al clinical lessons: (1) repeated vomiting unresponsive to anti-emetics warrants urgent investigation; (2) oxygen desaturation (3am) was a red flag requiring medical review and imaging which was not obtained; (3) Dr J.'s…
58y · Male·Aspiration pneumonia, in the setting of epilepsy and Down's syndrome
…, which did not respond adequately to antibiotic treatment. He deteriorated with increasing drowsiness and oxygen desaturation, and was subsequently transferred to palliative care. The coroner found the clinical care and…
47y · Male·Pulmonary thromboembolism in association with deep vein thrombosis
…l staff considered him low-risk based on the minimal invasiveness of laparoscopy. He developed progressive oxygen desaturations (80-90%) on 1 September requiring supplemental oxygen, which nursing and medical staff did n…
34y · Male·hypoxic-ischaemic encephalopathy following laparoscopic bariatric surgery with i…
…. He was admitted to HDU rather than ICU post-operatively. In HDU, he experienced repeated episodes of low oxygen saturation (33 alarms over 40 minutes including 3 crisis alarms) due to sleep apnoea and post-operative na…
53y · Male·fentanyl and oxycodone toxicity
…: failure to escalate care via mandated RaDAR protocols despite multiple trigger events (pain scores 9-10, oxygen desaturation to 88%, vomiting, excessive sedation); inadequate monitoring frequency (four-hourly rather th…
37y · Male·Acute asthma (thunderstorm asthma event)
…th suboptimal preventer medication use and recently diagnosed severe obstructive sleep apnea with profound oxygen desaturation. He was allergic to rye grass pollen and Alternaria mould. He ran out of reliever medication …
32y · Male·Pulmonary embolism originating from deep vein thrombosis in right calf
…xis was appropriately prescribed. However, the clinical team failed to investigate persistent hypoxia (low oxygen saturations 78-85%) from post-operative day 3 onwards. Critical failures included: incorrect completion of…
71y · Male·aspiration bronchopneumonia as a consequence of traumatic brain injury from a fa…
…onia in the Advanced Care Unit of Southern Queensland Correctional Centre. Critical clinical lessons: when oxygen saturations fell to 77% at 1:33pm, supplemental oxygen was not provided despite being available, no contin…
81y · Male·Retropubic and retroperitoneal haemorrhage complicating pelvic fractures with co…
…agulation; (3) no medical review overnight despite deteriorating vital signs (hypotension, bradycardia, desaturation); and (4) misdiagnosis of dehydration/possible MI on morning review, without considering pelvic bleedin…
48y · Male·Hypoxic brain injury following cardiac arrest in a patient with sigmoid colon vo…
…f acute bowel obstruction. Initial assessment identified sigmoid volvulus on imaging. He deteriorated with oxygen desaturation and suffered a cardiac arrest on 15 June 2004, requiring resuscitation. Emergency laparotomy …
33y · Male·Opiate toxicity
…ts—acknowledged as excessive by the physician who now recognizes this was inappropriate practice. Critical oxygen desaturations (79-90%) occurred throughout admission but were not recognized as a contraindication to furt…
76y · Male·Streptococcus pneumoniae sepsis in the setting of acute bronchopneumonia and ren…
…line was attributed to dementia and grief, potentially masking serious acute illness. On 6 July 2019, mild oxygen desaturation (91%) was documented but not escalated or monitored overnight. On 7 July 2019, staff underapp…
21y · Male·Hypoxic brain injury arising from severe anaphylactic shock due to administratio…
…ex (neuromuscular reversal agent), Lucas developed severe anaphylactic shock with bronchospasm, wheeze, desaturation and rapid loss of consciousness. Cardiac arrest ensued and required 23 minutes of CPR with appropriate …
31y · Male·Pulmonary thromboembolism
A 31-year-old man with obesity (BMI 40.2) and sleep apnoea underwent extensive cosmetic surgery in Malaysia (liposuction, abdominoplasty, chest lipectomy, and subsequent facial procedures) across two operations within fi…
56y · Male·Hypoxia and cardiac arrest with contributing conditions of Ischaemic Heart Disea…
…was used for this high-risk patient. During surgery, the patient experienced prolonged hypoxia with severe oxygen desaturation (53–78%), bradycardia (heart rate 26–40/min), and hypertension, none adequately recognised or…
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