ANZCA Fellowship Equipment and Safety Exam with ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
verified detailed solutions ||\\//|| ||\\//||
2022A14 Safety precautions and equipment requirements for providing anaesthesia in MRI - ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
correct answer✔✔MRI uses magnetic fields and radiowaves to image hydrogen atoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
abundant in fat and water. Numerous safety and equipment precautions must be taken to ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ensure safe anaesthesia care ||\\//|| ||\\//|| ||\\//||
EQUIPMENT REQUIREMENTS ||\\//||
- Must be MR safe or conditional
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Safe" equipment poses no additional hazard in any MR environment
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Conditional" equipment may have limits on static field strength, spatial gradient and rate
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
of change of magnetic field that it can be used with
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Unsafe" equipment poses a hazard in any MR environment and must not be used
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- All monitoring and anaesthetic equipment must conform to operating theatre and MR
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
safety standards ||\\//||
- E.g. Reports of burns from standard pulse oximeters, so fibreoptic and MRI-safe oximeters
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
are preferable, transmit signals via light vs electrical current
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Monitoring equipment should be kept outside the scanning room, meaning cables that are
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
required are long (invasive arterial line, capnography sampling line- which can lead to ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
damping, or delays in displayed waveform) ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
SAFETY PRECAUTIONS ||\\//||
1) BURNS PREVENTION
||\\//|| ||\\//||
- MR safe or conditional (checked) monitoring equipment only
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- All equipment checked prior to scanning
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,- Fibreoptic versus electrical cables
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Telemetric monitoring
||\\//|| ||\\//||
- MR safe ECG electrodes
||\\//|| ||\\//|| ||\\//|| ||\\//||
2) INJURY RELATED TO MAGNETIC FIELD/FERROMAGNETIC OBJECTS
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Patient and staff safety checklist to identify risks (implanted devices, foreign bodies in eye.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ferromagnetic cochlear implants, NSx clips, IABP/VAD, insulin pumps, aortic stent grafts). ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Most new PPM/AICDs compatible ||\\//|| ||\\//|| ||\\//||
- Remove all ferromagnetic objects
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Non-ferromagnetic equipment, drip stands, remove O2 cylinders from room
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Remove drug delivery patches
||\\//|| ||\\//|| ||\\//|| ||\\//||
3) ACOUSTIC NOISE ||\\//|| ||\\//||
- Typically above safe level of 85 dB
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Ear protection for all patients
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
4) ANAESTHETIC MACHINE AND CIRCUIT
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Remote site anaesthesia, ensure senior support available
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Equip ||\\//||
2022A10 Response to formal complaint made by a patient about you to your head of ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
department - correct answer✔✔- If used effectively feedback can improve practice and ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
patient care, identify system failures and areas for improvement and review
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- If handled promptly and well, complaints can be managed without the need for litigation or
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
seeking of compensation
||\\//|| ||\\//|| ||\\//||
REASONS FOR COMPLAINTS ||\\//|| ||\\//||
- Lack of understanding between anaesthetist and patient
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, - Poor communication/language/cultural barriers
||\\//|| ||\\//|| ||\\//||
- Lack of adequate information about events especially in emergency situations
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Patient does not want same thing to happen to others
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Negligence on part of practitioner or service
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Injury or complication of anaesthesia or surgery has occurred
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Litigation generally a last resort when other efforts fail
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
HOW TO HANDLE COMPLAINT ||\\//|| ||\\//|| ||\\//||
- There is no formula or specific model, but the following is a generic guide
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Have a suitably skilled member of staff (e.g. head of department, patient liaison officer
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
designated for handling complaints) ||\\//|| ||\\//|| ||\\//||
- APOLOGISE/OPEN DISCLOSURE: Acknowledge issue and express regret at patient distress.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Let patient know concerns will be investigated and addressed. Provide short written response
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
to complaint. Ensure this response is prompt
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- DOCUMENT/SEEK ADVICE: Concerns of patient, apology and explanation given in patient
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
notes/complaints register/discuss at morbidity and mortality meeting if ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
appropriate/warranted system issue. Contact medical indemnity provider (if ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
relevant/necessary) for advice on preparing response to both patient and employer ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- INVESTIGATE: Central issues of complaint, clarify with patient what they would like to
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
achieve. Person conducting Ix needs authority to make a decision on any actionable items
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- REPORT BACK TO PATIENT: In writing, and inform of steps taken
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Consider special needs of patient throughout process (e.g. interpreter)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- TAKE PREVENTATIVE STEPS: personal reflection and evaluation of clinica
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
verified detailed solutions ||\\//|| ||\\//||
2022A14 Safety precautions and equipment requirements for providing anaesthesia in MRI - ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
correct answer✔✔MRI uses magnetic fields and radiowaves to image hydrogen atoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
abundant in fat and water. Numerous safety and equipment precautions must be taken to ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ensure safe anaesthesia care ||\\//|| ||\\//|| ||\\//||
EQUIPMENT REQUIREMENTS ||\\//||
- Must be MR safe or conditional
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Safe" equipment poses no additional hazard in any MR environment
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Conditional" equipment may have limits on static field strength, spatial gradient and rate
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
of change of magnetic field that it can be used with
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- "Unsafe" equipment poses a hazard in any MR environment and must not be used
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- All monitoring and anaesthetic equipment must conform to operating theatre and MR
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
safety standards ||\\//||
- E.g. Reports of burns from standard pulse oximeters, so fibreoptic and MRI-safe oximeters
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
are preferable, transmit signals via light vs electrical current
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Monitoring equipment should be kept outside the scanning room, meaning cables that are
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
required are long (invasive arterial line, capnography sampling line- which can lead to ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
damping, or delays in displayed waveform) ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
SAFETY PRECAUTIONS ||\\//||
1) BURNS PREVENTION
||\\//|| ||\\//||
- MR safe or conditional (checked) monitoring equipment only
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- All equipment checked prior to scanning
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,- Fibreoptic versus electrical cables
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Telemetric monitoring
||\\//|| ||\\//||
- MR safe ECG electrodes
||\\//|| ||\\//|| ||\\//|| ||\\//||
2) INJURY RELATED TO MAGNETIC FIELD/FERROMAGNETIC OBJECTS
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Patient and staff safety checklist to identify risks (implanted devices, foreign bodies in eye.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ferromagnetic cochlear implants, NSx clips, IABP/VAD, insulin pumps, aortic stent grafts). ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Most new PPM/AICDs compatible ||\\//|| ||\\//|| ||\\//||
- Remove all ferromagnetic objects
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Non-ferromagnetic equipment, drip stands, remove O2 cylinders from room
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Remove drug delivery patches
||\\//|| ||\\//|| ||\\//|| ||\\//||
3) ACOUSTIC NOISE ||\\//|| ||\\//||
- Typically above safe level of 85 dB
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Ear protection for all patients
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
4) ANAESTHETIC MACHINE AND CIRCUIT
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Remote site anaesthesia, ensure senior support available
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Equip ||\\//||
2022A10 Response to formal complaint made by a patient about you to your head of ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
department - correct answer✔✔- If used effectively feedback can improve practice and ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
patient care, identify system failures and areas for improvement and review
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- If handled promptly and well, complaints can be managed without the need for litigation or
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
seeking of compensation
||\\//|| ||\\//|| ||\\//||
REASONS FOR COMPLAINTS ||\\//|| ||\\//||
- Lack of understanding between anaesthetist and patient
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, - Poor communication/language/cultural barriers
||\\//|| ||\\//|| ||\\//||
- Lack of adequate information about events especially in emergency situations
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Patient does not want same thing to happen to others
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Negligence on part of practitioner or service
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Injury or complication of anaesthesia or surgery has occurred
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Litigation generally a last resort when other efforts fail
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
HOW TO HANDLE COMPLAINT ||\\//|| ||\\//|| ||\\//||
- There is no formula or specific model, but the following is a generic guide
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Have a suitably skilled member of staff (e.g. head of department, patient liaison officer
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
designated for handling complaints) ||\\//|| ||\\//|| ||\\//||
- APOLOGISE/OPEN DISCLOSURE: Acknowledge issue and express regret at patient distress.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Let patient know concerns will be investigated and addressed. Provide short written response
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
to complaint. Ensure this response is prompt
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- DOCUMENT/SEEK ADVICE: Concerns of patient, apology and explanation given in patient
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
notes/complaints register/discuss at morbidity and mortality meeting if ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
appropriate/warranted system issue. Contact medical indemnity provider (if ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
relevant/necessary) for advice on preparing response to both patient and employer ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- INVESTIGATE: Central issues of complaint, clarify with patient what they would like to
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
achieve. Person conducting Ix needs authority to make a decision on any actionable items
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- REPORT BACK TO PATIENT: In writing, and inform of steps taken
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Consider special needs of patient throughout process (e.g. interpreter)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- TAKE PREVENTATIVE STEPS: personal reflection and evaluation of clinica
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
