Accidents OR Mishaps In Perfusion S.Lenin Chief Clinical Cardiac Perfusionist Royal Hospital Sultanate of Oman

Accidents OR Mishaps In Perfusion Occassional Often TWO Categories: Human error Equipment failures Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Human error Inadequate knowledge Carelessness Overconfidence Poor investigations Poor communication Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Human error Not only dedicated to ordinary situations Odd times Critical situations Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Human error Poor medical ethics Interdepartmental politics Or Ego Untidiness and disorganised setups Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Equipment failures: Very rare Unpredictable Unpreventable Electric Electronic Mechanical Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Equipment failures: Over work OR Fatigue Improper maintenance Wrong selection Poor manufacturing standards Can be traumatic or fatal Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Equipment failures: Attention, resolve at the earliest Failure attracts the attention of many Too many opinions Confusion - Perfusionist - Diversion Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Equipment failures: Loss of time leads to fatal results Leads to Mass Media Publication Sue the personnel Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Equipment failures: Successful management: New protocols Inventions Applications Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Accidents Only to Medical Field? Common to any given speciality. More common in teaching institutions Interns and Students Does not spare even the most experienced and in the hands of observers. Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion TO Err is human Acceptance gains knowledge Denial fools self Knowledge gets ignored Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion How to avoid accidents? Sound Knowledge Regular updates Regular Maintenance of equipments. Build up of trust and team spirit Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Trust is a natural and basic instinct We have to develop the trust within team members It is a bond which reassures and comforts. Strengthens the relationship Changes the quality of the person Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Follow the standards of perfusion Good data management Check list and double check Reconfirmation of settings Vigilant always Never be overconfident Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Good communication Sharpness in sight, hearing and reasoning Engage all the saftey gadgets on the HLM Widens the saftey window Machines have alarm, alert and auto shut off Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Saftey gadgets gives relaxation to the operating perfusionist Keep the safe timing limits Develop good organising skills Methodic approach Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Develop scanning pattern on vital parameters Enlighten the team - Plan Quick implementation Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Standards to follow: Document all the vital parameters, history of the Patient Appropriate the equipment selection and the disposables as per the patients need Never go with blind approaches Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Always read the drug label Never follow the color or shape of the vial or container May lead to increase in Morbidity and mortality Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Overcoming Accidents: Learning –An ongoing process –Universal –No age limit –Do not deny the opportunity Dedicate your time and age for achievements. Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Ultimate Goal: Save the life inspite of all the odd situations Prevent the re-occurrence Draft protocols and applications Be committed to the profession Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Ultimate Goal: Do not work for rewards alone Earn the confidence of the team Knowledge, hard work and efficiency Earns a better living Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Ultimate Goal: Sincereity, punctuality, honesty, vigilance, dedication, thorough knowledge and good communication Earns a good professional Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Medicine without team work is a SIN. Discuss the problems in common Share your experiences with the team Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion CONSTANT UPDATE Text books Media CME Conferences National, International Medical exhibitions Help to develop the management skills of the perfusionist Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Worldwide experience shows : Human errors > 90% Equipmental errors <10% Terumo conf.Dubai June 2002

Accidents OR Mishaps In Perfusion Terumo conf.Dubai June 2002