Expert: Dr Ian Jackson - please note UK based - 2/19/2009

Question
Hi Dr. Jackson,
I am starting the Nursing Program in the fall here in Nevada, and I was thinking about CRNA school after that. I know that anesthesiology is a high risk job, so I wanted to ask you in your experience, have you had any scary experiences with a patient not reacting correctly to a particular drug, and if so what was the cause?

Answer
Hi Christine
Your system is very different from ours in the UK so I can't comment about training.
However I can comment about the risks. Our job does have risks but our training helps to minimise these. Reactions to drugs can be very dramatic but form a very small part of these risks. Indeed problems with peoples airways or problems linked to blood loss are probably as frequent. The classic drug reaction is an anaphylaxis (or the slightly lesser anaphylactoid) reaction. In this the patients immune system reacts to the drug causes circulatory collapse - loss of blood pressure, difficulty breathing etc. This is dramatic but is seldom seen. More commonly people react to the side effects of the drugs we use eg a lot of them cause a drop in blood pressure. With these you can see an exagerated response and the patient can become quite hypotensive very quickly and you need to manage the situation or they may develop problems eg heart attack.
So if you want to do the job you need a cool head, attention to detail and to know the protocols for managing problems. Once you have that cracked it's a great job!
Dr Ian Jackson