Massive Pulmonary Embolism

“There were no other available extremities to place the pulse oximeter…The anesthesia provider…attempted to feel a carotid pulse, which was absent.”

Case Context    Provider Narrative    Lessons Learned

Case Context

Patient: middle-aged male
Presenting diagnosis: status post motor vehicle accident 8 days prior with > 50% body surface area burns (torso, chest, bilateral arms, half of his legs)
Planned procedure: irrigation and debridement of torso and arms, dressing changes, possible abdominal wound closure
Past medical history: smoking
Other pertinent information: patient to be transferred from the ICU to OR; required ongoing frequent crystalloid boluses to maintain mean arterial pressure (MAP) > 50 mmHg; right subclavian triple lumen in situ; ICU was unable to obtain arterial access due to the extent of his burns
Anesthetic plan:general endotracheal anesthesia