Sizing Up Surgery
Waking to a Nightmare
Although it is rare, some patients have
reported "awareness" or experiencing sensations while under anesthesia.
Those patients say they recall hearing snatches of conversations, being aware
of movement, and feeling pain. But whether this awareness really occurs or is
just the subconscious mind playing tricks that come back to haunt the conscious
mind has been subject to a lot of debate in the medical community. According to
Elting and Isenberg, when the anesthesia is weak, or the depth of
unconsciousness is purposely held shallow, the subconscious may provide its own
interpretations of what is happening and those interpretations may not
necessarily be accurate.
But whether or not awareness is real,
anesthesiologists are always on the lookout for indications of "light"
anesthesia, such as sweating or involuntary twitching. In these cases, says
Brenda Hayden, R.N., an interdisciplinary scientist with FDA's Center for
Devices and Radiological Health, the anesthesiologist would increase the
anesthesia to put the patient in a deeper state of unconsciousness.
According to the national Centers for Disease
Control and Prevention, approximately 2 million people a year contract
infections during a hospital stay, and nearly 90,000 die as the result. Urinary
tract infections, surgical wound infections, pneumonia, and bloodstream
infections annually are the most common hospital-acquired infections. Of those,
pneumonia and bloodstream infections cause the most deaths (about 34,000 and
25,000 respectively; infections from surgical wounds cause about 11,000 deaths,
and urinary tract infections 9,000). Those numbers would be far greater, CDC
says, without infection-control programs that have been required for hospital
accreditation since 1976. In fact, according to a recent CDC survey of 265
hospitals nationwide, without these programs, there would have been 50 to 70
percent more infections and deaths.
Hand washing is the single most important
procedure for preventing hospital-acquired infections, according to CDC.
Patients and their families should ask their health-care workers to follow good
hand washing practices, and bring it to their attention when they do not. In
addition, health-care professionals need to follow CDC guidelines and
recommendations on the use of intravenous lines and other medical devices, and
the proper use and administration of antibiotics.
Patients should alert their physicians or
nurses who are providing them care, or hospital administrators, if they have
concerns about their health-care workers' practices. All states have licensing
and oversight bodies in their state health departments that respond to concerns
and complaints brought by patients.
Patients should always provide their doctors
with a complete health history, including:
- other medications (some drugs may increase the risk for
- recent exposure to people or animals who might have
- travel to areas with high rates of infectious
If you become more ill after arriving home
from a hospital stay and develop unexpected symptoms such as pain, chills,
fever, discharge, or increased inflammation of a surgical wound, you should
alert your doctor.