Hypoxia.
· Text mentions that the cardiac arrest is mainly neurogenic and any irritation of the respiratory tract, such as laryngoscope or intubations may cause a lightly anesthetized patient to have a cardiac arrest.
· Hypoxia is a potent precipitating factor in cardiac arrest, either from faults in the apparatus or more commonly due to inexperienced anesthetist, especially in handling the equipments with which he is not familiar. An overdose of the anesthetic agent depresses the respiratory centre and begins a descending spell of hypoxia.
· Airway obstruction is another danger which may be blood, teeth, and dentures inside the tract or faults in the connecting tube, laryngeal spasm, swabs and an abnormal posture of neck.
· Regurgitation of gastric contents is a real danger and I have seen this in many cases.
· From the autopsy surgeon’s point of view, the finding of gastric contents in the airways must be backed up some clinical evidence of its ante-mortem origins before making any conclusion because many bodies has some gastric contents in some part of the air passage at the time of autopsy, mostly as a result of postmortem transfer that is a consequence of the dying process and not a cause of death.
· Some physical faults in the anesthetic equipment such as faults in the connecting tube which may be internal delamination not seen from outside, may cause death.
· Flowmeter errors occur, but confusion of bottled or pipe gas supplies or the connection of an empty cylinder are more common.
· Any electric appliance is potentially dangerous and defective cauteries, defibrillators and diathermy equipments have all caused death.
· Explosion from inflammable gases and vapors during intervention have also caused death
(Contributed by Dr Sudhir Gupta)
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