Vital Signs
BMA News, 20th October 2007.
Aidan M. O’Donnell.
Nicki was 23 and required a minor gynaecological procedure as a day case. As the anaesthetic registrar, I went to assess her beforehand.
Her history and examination presented no concerns. As I described the anaesthetic, however, she blanched when I mentioned the cannula in her hand.
“I hate needles,” she told me. “Can’t I just get the gas?”
This was somewhat unexpected, as it had not escaped my attention that she had a lot of piercings. One eyebrow had two rings. Both ears had lobe, helix and tragus piercings. She had a tongue stud and a nostril stud. She also had tattoos on her arms.
I challenged her about the piercings. “Surely,” I said, “you managed to tolerate all those piercings?”
“Oh, no. I couldn’t do it. I had to get knocked out for it,” she replied, unguardedly.
I was bewildered. “Knocked out? As in, put to sleep?”
“That’s right. They gave me this stuff and I was knocked out.”
“Who gave you the stuff? The hospital?”
She became suddenly guarded. “Erm… yeah.”
“What sort of stuff?”
“It was, erm, tablets. It wasn’t the hospital, it was my own doctor.”
“And where did you get the piercings done?”
“It was, erm, Joe’s Skin Shop.” She named the town.
I left the room in a turmoil. At least one interpretation of these statements is that there was a tattoo parlour where you could go, and if you were a bit nervous, they could give you some stuff which made you go to sleep while they did it. This would be, not simply illegal on a variety of counts, but also potentially deadly to some unfortunate victim.
Unfortunately, my clumsy questioning had caused Nicki to clam up without revealing any of the vital details. Joe (or whoever) had probably cautioned her to keep very quiet about it.
To cover the bases, I telephoned her GP, who said that under no circumstances would he prescribe an anxiolytic for a piercing or tattoo, and Nicki’s file indicated no such prescription.
Next, I telephoned the police and reported my concerns to a very helpful officer. I stressed there was a potential risk to the public. They subsequently looked into it, but found no evidence of crime.
Finally, I gave Nicki an inhalational induction, and she had an uneventful anaesthetic.
Faced with this situation, I did everything I could to ensure safety of my patient and the public, but I still sometimes scan the news for reports of an unexpected death in a tattoo parlour. So far, there have been none.
Aidan O’Donnell is a consultant anaesthetist from Livingston, West Lothian.
Copyright © Aidan O’Donnell 2007.
This article first appeared in BMA News on 20th October 2007.
Unauthorised reproduction prohibited.
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