Reviewing Anesthesia Near Misses with Aortic Stenosis and Other Issues, with Dr. Paul Rollins

Everyday Oral Surgery

Anesthesia is critical to surgical procedures, ensuring patients are comfortable and pain-free during operations. However, administering anesthesia is not without risks, especially for patients with underlying health conditions like aortic stenosis. In this episode, we are joined by Dr. Paul Rollins, Oral Surgeon at Falls Oral Surgery & Dental Implant Center, to explore some of his anesthesia near misses with patients. Learn about the basics of aortic stenosis, what the symptoms are, and how to identify it before administering anesthesia. Discover how to differentiate between aortic stenosis and Still’s murmur, why you need a high-quality stethoscope, and how to identify a diastolic murmur. We also delve into the process that follows after reliably identifying aortic stenosis, the pitfalls of relying completely on advisors for clearance, and the importance of maintaining a patient’s blood pressure while avoiding hypertension during anesthesia. Gain insight into other issues to consider before administering general anesthesia, the importance of asking questions, and more. Join us as we learn about some of the ways anesthesia can go wrong and how to avoid them with Dr. Paul Rollins!

Key Points From This Episode:

• Why case reviews are so valuable for preventing problems.
• First case: an older male who exhibited aortic stenosis before general anesthesia.
• Second case: an older male with hypertension who exhibited a clear aortic stenosis.
• Third case: an older male diagnosed with aortic stenosis but cleared for general anesthesia.
• Fourth case: an anxious older female who had an obvious red flag.
• Fifth case: an older female who misrepresented her medical history.
• Dr. Rollins’ final takeaways and valuable advice for listeners!

Quotes:

“One the most frightening things about healthcare, what we do on a daily basis, and healthcare in general is we base so much of what we do on what the patient tells us about their history.” — Dr. Paul Rollins [0:04:00]

“Once a patient becomes symptomatic with aortic stenosis, the mortality rate approaches 50% within two years without any intervention.” — Dr. Paul Rollins [0:07:14]

“Sometimes [aortic stenosis] murmurs are so loud that you will hear it almost anywhere on the chest.” — Dr. Paul Rollins [0:18:51]

“If you hear a diastolic murmur, don’t move forward with the case. Get it diagnosed and figured out first.” — Dr. Paul Rollins [0:29:00]

“Never do something that you are uncomfortable doing because a patient is trying to pressure you into doing it.” — Dr. Paul Rollins [0:32:18]

Links Mentioned in Today’s Episode:

Dr. Paul Rollins — linkedin.com/in/paul-rollins-25248848

Falls Oral Surgery & Dental Implant Center — fallsoralsurgery.com

Shōgun — imdb.com/title/tt2788316

Narcos — imdb.com/title/tt2707408

The Gentlemen — imdb.com/title/tt13210838

The Little Book of Common Sense Investing — amazon.com/dp/1119404509

Man's Search for Meaning — amazon.com/dp/1846042844/

Everyday Oral Surgery Website — everydayoralsurgery.com

Dr. Grant Stucki Email — [e-mail]

Dr. Grant Stucki Phone — 720-441-6059