Patient safety incident review: fluid replacement considerations in liposuction procedures
The following information and recommendations are being shared to assist medical directors of facilities in their continuous quality improvement.
The Non-Hospital Medical and Surgical Facilities Patient Safety Incident Review Panel recently reviewed an incident involving a near miss where a patient was severely fluid deficient following a liposuction procedure. The fluid deficit may have been as much as 3500 cc, which could have led to serious complications.
The following recommendations provided to the facility involved are important to keep in mind when dealing with this situation:
- Non-Hospital Medical and Surgical Facilities Accreditation Program (NHMSFAP) Liposuction Guidelines state total aspirate should not exceed 5000 cc. Liposuction procedures exceeding this limit are reportable to the College as a patient safety incident.
- A fluid replacement strategy for large volume liposuction must be developed to ensure appropriate fluid balance. Aspirate versus input must be carefully recorded.
- The wetting solution administered appeared deficient in the case reviewed. The clinical team must consider the amount of volume in when calculating fluid replacement.
- Communication between the surgeon and anesthetist is vital to ensuring proper fluid replacement to ensure patient safety.
Medical directors and clinical leads are encouraged to share this information with the clinical team and review protocols for fluid replacement for liposuction procedures.