Module 23 — Complications: Prevention, Recognition, Management

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Lyrics

[Verse 1]
Scrub in, gloved up, the dura's open wide
Assume the complication's already waiting inside
Arterial bleed from a perforator you nicked
Sinus laceration — gauze, pressure, think quick
Brain swelling climbing like barometric dread
Differential running: CO2, venous, blood spread
Air embolism hissing through the field unseen
Call the anaesthetist, flood the wound, intervene

[Chorus]
Las complicaciones van a llegar, es verdad
Detect them early, manage them with care
No esperes — the hematoma won't wait
Reimage, return to theatre, don't hesitate
Reconoce, actúa, documenta también
Early recognition — that's the surgeon's refrain

[Verse 2]
Endonasal case, the carotid tore free
Pack it hard, call endovascular, that's the decree
Rehearse that drill before you ever need it live
A team that's practiced panics less and keeps the patient alive
Wrong site, retained sponge, corneal graze from tape
Position injuries — ulnar, brachial — no escape
Every sentinel moment logged before you close
Checklist, briefing, count — that's how precision grows

[Chorus]
Las complicaciones van a llegar, es verdad
Detect them early, manage them with care
No esperes — the hematoma won't wait
Reimage, return to theatre, don't hesitate
Reconoce, actúa, documenta también
Early recognition — that's the surgeon's refrain

[Verse 3]
Post-op and the patient won't wake — don't just observe
Structured differential: hematoma, seizure, metabolic curve
Epidural, subdural, intraparenchymal clot
Remote cerebellar hemorrhage — rarer, but it's not
Sodium crashing after sellar resection done
Endocrine failure, VTE, pneumonia — run
The systemic list before one symptom slips your eye
Delirium, PE, stress ulcer — all apply

[Bridge]
En la sala de M&M, presenta tu caso
Con sistemas rotos, no solo el error del brazo
Root cause analysis — cognitive bias named
Human factors mapped before the blame's been claimed
Failure-to-rescue is the metric on the wall
Registry data shows you where the edges fall
Standardized handover, debrief after each case
Quality infrastructure holding safety's place

[Verse 4]
New deficit post-op: image first, then decide
Reopen if the clot explains what the exam described
The disclosure conversation — measured, clear, and true
Apologize with documentation, jurisdiction-reviewed
The family deserves a surgeon who won't hide behind the chart
Honesty mapped onto the notes — that's the clinical art
M&M isn't punishment, it's where the practice bends
Concrete change from root cause — that's where the module ends

[Chorus]
Las complicaciones van a llegar, es verdad
Detect them early, manage them with care
No esperes — the hematoma won't wait
Reimage, return to theatre, don't hesitate
Reconoce, actúa, documenta también
Early recognition — that's the surgeon's refrain

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