Anesthesia‐related critical incidents in the perioperative period in children; a proposal for an anesthesia‐related reporting system for critical incidents in children

Abstract

Respiratory events were the most reported commonly critical incidents in children. Both the Dutch and German existing lists of critical incident definitions appeared not to be sufficient for accurate classification in children. The present list can be used for a new registration system for critical incidents in pediatric anesthesia.

A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

“…11,12,45,[47][48][49] Perioperative mortality trends may initially increase in middleincome countries with increasing access to surgical care, the increased provision of surgery for unwell patients undergoing complex procedures, and more reliable data. 9,11,12,19,29 A 2014 study from Brazil demonstrated this, as 24-hour perioperative mortality increased when compared against the incidence of mortality reported in previous studies. 11,47,50 Anaesthetic-related mortality increases by a factor of 50-100 in low-income countries, but may be 1 000-fold higher in certain poor countries.…”

“…14,29 Anaesthetic-related critical incidents are three times more common in children, and occur in 3-8% of all anaesthetics, revealing high nonfatal event rates, even in high-income countries. 29,42,46,57 Limited data in lowincome countries expose a critical incident rate double that of high-and middle-income countries. 60 More events are associated with infants and inexperienced practitioners, 59,60 and respiratory events involving ear, nose and throat surgery.…”

“…Critical incidents measure a wider variety of events, including "near misses" and have been defined as "any event that affected, or could have affected, the safety of the patient while under the care of an anaesthetist from the induction of anaesthesia until discharge from the post-anaesthesia care unit". 29 Discrimination is lacking with the use of adult reporting tools in paediatric events. 29 Paediatric-specific monitoring tools have been devised in the Wake Up Safe programme for serious adverse events (Table 2), 14,16 and by de Graff et al, for critical incidents.…”

“…29 Discrimination is lacking with the use of adult reporting tools in paediatric events. 29 Paediatric-specific monitoring tools have been devised in the Wake Up Safe programme for serious adverse events (Table 2), 14,16 and by de Graff et al, for critical incidents. 29…”

“…23,27,28 Therefore, quoted incidences vary, making comparison between studies difficult, and resulting in potentially misleading conclusions. 12,16,23,[27][28][29] Anaesthetic-related mortality or cardiac arrest…”