What a anesthesiology review usually focuses on

Airway, dosing, monitoring, and recovery. A case review should reconstruct the sequence of airway assessment, medication dosing, physiologic monitoring, intraoperative response, and recovery from the records available at each decision point.

Five decision points to map

  • 1. Airway assessment
  • 2. Medication dosing
  • 3. Physiologic monitoring
  • 4. Intraoperative response
  • 5. Recovery

Records that can answer those questions

  • Anesthesiology consultation, procedure, or encounter notes
  • Orders and test results used to make the clinical decision
  • Medication, monitoring, procedure, or nursing records tied to the event
  • Communication with the patient and other specialties
  • Later treatment showing the complication, corrected diagnosis, or outcome

Expert and causation questions

  • What training and specialty should the reviewing anesthesiology expert have under state law?
  • Which of the key decision points in airway, dosing, monitoring, and recovery is actually being challenged?
  • What information was available at that time, not only in hindsight?
  • What part of the later harm is attributable to the underlying illness or known risk?
  • Would a different medical decision probably have changed treatment or outcome?

Related specialties

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Use licensing, records, and medical-information sources appropriate to the specialty.