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Jan/Feb 2015

Enhancing the Art of Care During Awake Procedures

Author Affiliations
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
  • 2Neurosensory Disorder Center, University of Cincinnati Neuroscience Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
JAMA Facial Plast Surg. 2015;17(1):5-6. doi:10.1001/jamafacial.2014.1026

“Please stop, I can’t lie still while you inject my face.” The patient’s plea, infused with fear, would not be numbed by the local anesthetic that the young physician was trying to administer for this awake procedure. Pausing outside the procedure room, I heard the curt response of “Just be still” by this pressed-for-time young physician.

I do not know the circumstances or what happened next to this patient or young physician, or to their relationship. However, this interaction brought to my attention the likelihood that such a situation involving a hurried young physician and a vulnerable patient might occur more often in the classic clinical scenario in modern medical practice. Although technological advances enable many procedures to now be performed on patients who are awake rather than under general anesthesia, elevating the art of patient comfort during such awake procedures is an important point to instruct in our teaching programs.

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