A Multiple-Hospital Anaesthetic Problem Register: Establishment of a Regionally Organized System for Facilitated Reporting of Potentially Recurring Anaesthetic-Related Problems

Kerridge, Ross; Crittenden, M. B.; Vutukuri, V. L. S. P.

doi:10.1177/0310057x0102900203

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…Some societies and individual hospitals elsewhere, however, have maintained their own database. [18][19][20] 1. Pearce A. NAP4 Project-Assessment and planning.…”

Section: The Role Of Databasementioning

confidence: 99%

Airway Assessment by Non-anaesthetists

Amponsah¹

2022

pmjg

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Patients who may require surgery, visit our hospitals daily. Various forms of anaesthesia are given for these surgeries, which include local, regional and general anaesthesia. General anaesthesia may involve the use of devices to maintain a secure and safe airway.The improper management of the airway is still an important cause of morbidity and even mortality in anaesthetic practice. This paper seeks to give guidelines for the non-anaesthetist to be able to identify patients whose airway may be difficult to manage duringsurgery, since the surgeons see the patients first, long before the anaesthetist does. These airway assessment guidelines have been given based on the various surgical specialties such as general surgery, maxillofacial and neurosurgery. Specific surgicaldisorders which have a relatively high percentage of difficult airway have been discussed. They include goitre, mediastinal masses, abscesses and burns around the head and neck. Medical conditions such as diabetes mellitus with expected difficult airway have also been discussed. A simple algorithm has been added as an additional guide. The paper ends with recommendations which include the establishment of difficult airway database and the running of regular workshops for anaesthetists and non-anaesthetists as a means of maintaining skills in the management of the airway of the surgical patient and thus improve on their outcome.

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“…Some societies and individual hospitals elsewhere, however, have maintained their own database. [18][19][20] 1. Pearce A. NAP4 Project-Assessment and planning.…”

Section: The Role Of Databasementioning

confidence: 99%

Airway Assessment by Non-anaesthetists

Amponsah¹

2022

pmjg

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“…The retrieval of important information of a particular patient, when linked to AIMS can be really helpful during emergency situations such as difficult airway, cardiac arrest, and trauma . A situation may rarely arise in which the identity is not known of an unconscious patient requiring acute surgery (e.g., those suffering acute trauma).…”

Section: Uses Of Datamentioning

confidence: 99%

Paperless anesthesia: uses and abuses of these data

Anderson

Merry

2015

Pediatric Anesthesia

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Demonstrably accurate records facilitate clinical decision making, improve patient safety, provide better defense against frivolous lawsuits, and enable better medical policy decisions. Anesthesia Information Management Systems (AIMS) have the potential to improve on the accuracy and reliability of handwritten records. Interfaces with electronic recording systems within the hospital or wider community allow correlation of anesthesia relevant data with biochemistry laboratory results, billing sections, radiological units, pharmacy, earlier patient records, and other systems. Electronic storage of large and accurate datasets has lent itself to quality assurance, enhancement of patient safety, research, cost containment, scheduling, anesthesia training initiatives, and has even stimulated organizational change. The time for record making may be increased by AIMS, but in some cases has been reduced. The question of impact on vigilance is not entirely settled, but substantial negative effects seem to be unlikely. The usefulness of these large databases depends on the accuracy of data and they may be incorrect or incomplete. Consequent biases are threats to the validity of research results. Data mining of biomedical databases makes it easier for individuals with political, social, or economic agendas to generate misleading research findings for the purpose of manipulating public opinion and swaying policymakers. There remains a fear that accessibility of data may have undesirable regulatory or legal consequences. Increasing regulation of treatment options during the perioperative period through regulated policies could reduce autonomy for clinicians. These fears are as yet unsubstantiated.

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“…Following testing, all patients were provided with a card outlining the nature of their reactivity to carry with them. They were also encouraged to wear a Medicalert bracelet outlining their sensitisation and an alert of their reactivity was entered on a regional anaesthetic database for future reference by local anaesthetists 24 . Adrenaline for use in acute emergency was provided for two patients where sensitisation was identified to allergens likely to be encountered in daily life.…”

Section: Suspected Hypersensitivity Reactionmentioning

confidence: 99%

Review of Procedures for Investigation of Anaesthesia-Associated Anaphylaxis in Newcastle, Australia

McNeill

2008

Anaesth Intensive Care

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The procedures, results and outcomes of investigation of 50 patients with clinical episodes of anaesthesia-associated anaphylaxis were retrospectively reviewed. Assessment was performed by measurement of serum tryptase and specific IgE and a combination of skin prick and intradermal skin testing. Testing was performed both for agents received during the anaesthetic and for agents the patient may encounter in future procedures. Twenty of 50 patients underwent a subsequent procedure after assessment. Sensitisation to neuromuscular blocking agents was identified in 18 patients (36%). Sensitisation to propofol (14 patients; 28%) and latex (four patients; 8%) was also frequently identified. No precise cause was identified in 11 cases (22%). Reactivity to more than one agent was identified in 14 patients (28%). Serum tryptase was measured within six hours of the episode in only 28 of the 50 cases. All the patients with elevated serum tryptase had clinically severe reactions. One patient initially found to be sensitised to propofol had another reaction during a second procedure, prompting further assessment where chlorhexidine reactivity was identified. Subsequent surgery in that patient and in 19 other patients where agents implicated in the testing were avoided, proceeded without incident. The results reaffirm that neuromuscular blocking agents are the most common cause of anaphylaxis during anaesthesia. The importance of serum tryptase measurement at the time of the acute episode needs to be emphasised. Investigation should include screening for chlorhexidine and latex in all patients, as exposure to both these agents is common and may be overlooked.

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A Multiple-Hospital Anaesthetic Problem Register: Establishment of a Regionally Organized System for Facilitated Reporting of Potentially Recurring Anaesthetic-Related Problems

Cited by 11 publications

References 16 publications

Airway Assessment by Non-anaesthetists

Airway Assessment by Non-anaesthetists

Paperless anesthesia: uses and abuses of these data

Review of Procedures for Investigation of Anaesthesia-Associated Anaphylaxis in Newcastle, Australia

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