RISK MANAGEMENT AMONG PATIENTS WITH SY GUILIAIN-BARRE AND ACUTE CHIRURGICAL DISEASE - presentation of the case with focus on the needed establishment of the national database of the risk cases
Authors: Cvetković M. , Cvetković V. , Nikolić M. , Vitić E. 
Published: November 2024

&lt;p&gt;Every anesthesiologist can meet during his/her work with the patients who are suffering from rare diseases and had to be treated with surgical procedures. In a large clinical centers availability of the equipment, mentors and continual professional education are factors that are making performances of anesthesiologist&#039;s much easier. Regional hospitals, including our own one, are in much disadvantaged position. Health Center Kosovska Mitrovica is providing health treatment from the territory of Kosovo and Metohija. Due to the limited freedom of movement, these patients have to be treated &quot;immediately and at place&quot;. Through the presentation of the case of the patient with Guillain-Barre (GBS) syndrome, we would like to underline a need for the establishment of the informational availability system through Point-of-Care Call on Line Electronic Help (OLEH) programme as it would significantly reduce the incidents related to the injuries and death cases caused by anesthesiologist procedures. Presentation of the case: Female, 42 years of age, a neurological patient with a th number of years of diagnosed illness was accepted on 13 February 2006 at the surgical department due to the abdominal pain, constipation and difficult urination. It was identified and diagnosticallv confirmed that uterus cancer spread out towards the colon, jeopardizing the bladder. It was decided that surgical procedure is reouired. Anesthesiology risk management evaluation started from the introduction with GBS. The case reviled acute inflammatory neuropathy with denivelization as the outcome of the antibodies reaction on the peripheral nerves. Chronically occurred types fas it was our easel, could lead to disruptions in breading, weakening of the muscle structure, areflection, pareses of orofaringealy physique, ophtamoplegy, chvadriplegy and chronical lung hearth. Strategy of the anesthesiological approach within the risk management procedures considered safe guidance of the patient through the pre and post anesthesioloqical period. Problem occurred was related to the limited availability of the professional literature and on-place resources related to the holistic experiences in treatment of this kind of problematic cases. The only sure available guideline was related to the avoidance of the depolarizing relaxants, which we have practiced. Within the work, we have described in details pre. peri and post anesthesiological approaches towards this problem. Conclusion: Recognition of the risk factors and multidisciplinary approach showed efficient during the peri and early post operational period. We have to indicate that development of the basic disease could have been much slower if we had assistance in respect to at-hand available and holistic information&#039;s on the rare diseases focused on the anesthesiological treatments. Therefore, it is our opinion that more qualitative system of health insurance has to introduce implementation of the hospital services standards, monitoring of the implementation and establishment of the electronic database. Developed countries such are i.e. USA, France, Italy, etc, have already introduced similar practices aimed to reduce morbidity and mortality among the patients&lt;/p&gt;