Every time a patient was to receive general anesthesia for surgery, hospital policies stated that an adequate intravenous line should be present to administer necessary fluids and medications, in a recent case decided by the Court of Appeal of Louisiana.

  A nineteen-month-old patient was brought in for what was expected to be a simple, routine procedure to incise the tympanic membranes to remove middle ear fluid and to install drainage tubes, to remove the adenoids and to clear the maxillary sinuses by needle puncture.

  The parents met with the circulating nurse before the procedure. She reviewed the surgical consent form with them, told them the child would be placed under general anesthesia and explained there were certain generic risks associated with general surgical anesthesia. The nurse also received a negative response to her inquiry whether any member of the child’s family was known to have experienced an adverse reaction to surgical anesthesia.

  In the operating room, after the child was asleep, the physician attempted unsuccessfully to insert a standard pediatric IV line at four different sites. Because the procedure was expected to be quite brief and to involve minimal blood loss, the physician then elected to proceed without an IV in place.