No Fiberoptic Intubation System: A Potential Problem -- Is the Patient Extubated? -- A Strange Computerized Electrocardiogram Interpretation -- Fractured Neck of Femur in an Elderly Patient -- Spinal Anesthetic That Wears Off Before Surgery Ends -- Just a Simple Monitored Anesthesia Care Case -- Smell of Burning in the Operating Room -- Inguinal Hernia Repair in a Diabetic Patient -- The Case of the “Hidden” IV -- Postoperative Painful Eye -- Awake Craniotomy with Language Mapping -- Gum Elastic Bougie: Tips for Its Use -- External Vaporizer Leak During Anesthesia -- Manual Ventilation by a Single Operator: With Patient Turned 180 Degrees Away from the Anesthesia Machine -- Life-Threatening Arrhythmia in an Infant -- Tongue Ring: Anesthetic Risks and Potential Complications -- Hasty C-Arm Positioning: A Recipe for Disaster -- Inability to Remove a Nasogastric Tube -- An Unusual Cause of Difficult Tracheal Intubation -- Pulmonary Edema After Abdominal Laparoscopy -- Difficult Laryngeal Mask Airway Placement: A Possible Solution -- Postoperative Airway Complication After Sinus Surgery -- An Unusual Capnograph Tracing -- A Respiratory Dilemma During a Transjugular Intrahepatic Portosystemic Shunt Procedure -- A Tracheostomy Is Urgently Needed, but You Have Never Done One -- General Anesthesia for a Patient with a Difficult Airway and a Full Stomach -- Jehovah’s Witness and a Potentially Bloody Operation -- Intraoperative Insufflation of the Stomach -- Sudden Intraoperative Hypotension -- Overestimation of Blood Pressure from an Arterial Pressure Line -- Severe Decrease in Lung Compliance During a Code Blue -- Shortening Postanesthesia Recovery Time After an Epidural: Is It Possible? -- Difficult Airway in an Underequipped Setting -- Delayed Cutaneous Fluid Leak After Removal of an Epidural Catheter -- Traumatic Hemothorax and Same-Side Central Venous Access -- Single Abdominal Knife Wound? Easy Case? -- A Draw-Over Vaporizer with a Nonrebreathing Circuit -- Unexpected Intraoperative “Oozing” -- Central Venous Access and the Obese Patient -- Taking Over for a Colleague: Always a Potential Concern -- Intraoperative Epidural Catheter Malfunction -- Breathing Difficulties After an Electroconvulsive Therapy -- White “Clumps” in the Blood Sample from an Arterial Line: Are You Concerned? -- Anesthesia for a Surgeon Who Has Previously Lost His Privileges -- Airway Obstruction in a Prone Patient -- A Question You Should Always Ask -- Postoperative Vocal Cord Paralysis -- A Serious Problem -- A Leaking Endotracheal Tube in a Prone Patient -- Lessons from the Field: Unusual Problems Require Unusual Solutions in Impossible Situations -- An “Old Trick” but a Potential Problem -- A Loud “Pop” Intraoperatively and Now You Cannot Ventilate -- Postoperative Median Nerve Injury -- A Patient in a Halo: Watch Out -- Now or Never: Developing Professional Judgment -- General Anesthesia in a Patient with Chronic Amphetamine Use -- What Is Wrong with This Picture? -- The One-Eyed Patient -- A Near Tragedy -- Robot-Assisted Surgery: A Word of Caution -- An Airway Emergency in an Out of Hospital Surgical Office -- Bonus Question: Is the Patient Paralyzed?.

Although near-miss situations are fortunately rare in anesthesiology, it is essential to know how to respond if these situations arise. This collection of actual cases, compiled from the author’s thirty-five plus years of practice in major metropolitan hospitals in the United States, Norway, and South Africa, is an excellent review of potential problems and solutions all anesthesiologists should be familiar with. Succinct case presentations describe a problem and the solution, with each write-up concluded by a retrospective analysis examining whether the solution used was actually the best (or only) choice. Other solutions and equally satisfactory outcomes are explored, and tips to help avoid problems altogether are presented where possible. This book may therefore serve as either an excellent review for the American Board of Anesthesiology’s oral exam or as an easy and practical way for the reader to gain familiarity with unexpected problems in clinical anesthesia. .