Hp1

PE Labs Imaging

Gross Pathology Micro Pathology Treatment

Discussion

A 23-year-old female is suing her physician for sexually abusing her while he was reducing her left dislocated shoulder.

She injured her shoulder while rock climbing in Colorado. The doctor was called upon to see her immediately after the accident. She did not suffer major injuries but had a dislocated shoulder and was not cooperative enough to tolerate the procedure (reduction) without medical ion, so he anesthetized her with ketamine, atropine, and diazepam.

X-rays at time of injury showed an anterior shoulder dislocation.

The addition of diazepam and atropine often diminishes the hallucinogenic effect of ketamine.

Ketamine is an arylcyclohexylamine that produces a dissociative anesthesia; the patient has open eyes and her muscle tone is preserved (with sufficient analgesia to do major surgery and total amnesia). Ils major side effect is vivid hallucinations, sometimes terrifying, upon arousal, mostly in adults. It is widely used in developing countries, in rural areas where there is no available anesthesiologist, and in short pediatric procedures (abscess debridement, burn wounds, dressing changes, etc.) because of its relative safety and lack of life-threatening side effects (such as respiratory depression, which is common with other anesthetics). p.280

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