Abstract:The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient … Show more
“…Intervention radiological techniques are being utilized frequently for anticipated or unanticipated cases of MOH. [ 19 ] Catheters with balloons at the distal end are placed in the uterine or iliac arteries; the balloons may be prophylactically inflated during the surgical procedure (after delivery of the foetus in case of caesarean sections), or whenever needed.…”
One of the most important causes of maternal mortality is major obstetric haemorrhage. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. The management consists of fluid resuscitation, administration of blood and blood products, conservative measures such as uterine cavity tamponade and sutures, and finally hysterectomy. Blood transfusion strategies have changed over the last decade with emphasis on use of fresh frozen plasma, platelets, and fibrinogen. Point-of-care testing for treating coagulopathies promptly and interventional radiological procedures have further revolutionized the management of such cases.
“…Intervention radiological techniques are being utilized frequently for anticipated or unanticipated cases of MOH. [ 19 ] Catheters with balloons at the distal end are placed in the uterine or iliac arteries; the balloons may be prophylactically inflated during the surgical procedure (after delivery of the foetus in case of caesarean sections), or whenever needed.…”
One of the most important causes of maternal mortality is major obstetric haemorrhage. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. The management consists of fluid resuscitation, administration of blood and blood products, conservative measures such as uterine cavity tamponade and sutures, and finally hysterectomy. Blood transfusion strategies have changed over the last decade with emphasis on use of fresh frozen plasma, platelets, and fibrinogen. Point-of-care testing for treating coagulopathies promptly and interventional radiological procedures have further revolutionized the management of such cases.
“…5 ). 35 Generally staffing of the IR suite itself requires one or more interventional radiologists, nurses, radiology technologists, and ancillary staff. Staffing is guided by patient safety and resource efficiencies.…”
Section: Introductionmentioning
confidence: 99%
“…The anesthesiologist is available for procedures requiring general anesthesia or moderate-deep sedation in selected cases (transjugular intrahepatic portosystemic shunt, intracranial vascular procedures, hemorrhagic urgencies, pediatric patients). 35 , 36 Figure 5 Operating theater with C-arm positioned for interventional procedures; the beam source is positioned below the patient and should be at maximum distance from the patient (white dotted arrow). …”
Section: Introductionmentioning
confidence: 99%
“…If catheters are placed electively in the radiology suite with subsequent transfer of the woman to obstetric theater for the caesarean section, then there is a risk of sheath and catheter displacement during transport. 35 In fact, good communication among a multidisciplinary team consisting of the interventional radiologist, obstetrician, anesthesiologist, nursing, and ancillary staff is essential for the safe and efficient management of these patients. Specific issues that should be discussed include fetal monitoring (equipment and nursing staff), recovery location (immediate postprocedure and intermediate-term and long-term recovery), and resource availability in the event of an emergency delivery.…”
Section: Introductionmentioning
confidence: 99%
“…Specific issues that should be discussed include fetal monitoring (equipment and nursing staff), recovery location (immediate postprocedure and intermediate-term and long-term recovery), and resource availability in the event of an emergency delivery. 35 …”
Interventional radiology is continuing to reshape current practice in many specialties of clinical care and the fields of gynecology and obstetrics are no exception. Imaging skills, clinical knowledge as well as vascular and non-vascular interventional technical ability, are essential to practice interventional radiology effectively. Patient safety is of paramount importance in interventional radiology as in all branches of medicine. Potential failures occur throughout successful procedures and are attributed to a spectrum of errors, including equipment unavailability, planning errors, and communication errors. These are mainly preventable by improved preprocedural planning and teamwork. Of all the targeted and effective actions that can be undertaken to reduce adverse events, the use of safety checklists might have a prominent role. The advantage of a safety checklist for interventional radiology is that it guarantees that human error in terms of forgetting key steps in patient preparation, intraprocedural care, and postoperative care are not forgotten.
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