Attitude of anaesthetists to intra-operative catastrophes: a questionnaire survey

Abstract

Background: Although anaesthetic deaths are uncommon, most anaesthetists are likely to be involved with an anaesthetic catastrophe at some point in their careers. This experience may have significant psychological impact on the staff concerned. Formal incident reporting accompanies anaesthetic deaths, and in addition involved personnel frequently need professional counseling. Objective: To determine the impact and attitude of Nigerian anaesthetists towards an intra-operative death. Method: A structured-questionnaire survey of 65 Nigerian physician anaesthetists, of all grades, attending a National Anaesthetic Scientific forum, was carried out to collect relevant information using a descriptive study design. Nurse anaesthetists were excluded from the study. Data was analysed using simple mathematical correlates. Results: The response rate was 86%. Out of a total mortality of 77, 48 (62%) were unanticipated. Emergency procedures accounted for 61 (79%) of these mortalities. Only 32 (41%) of the critical incidents were formally reported. Forty-eighty (86%) of the respondents were psychologically affected by the intraoperative catastrophes reported. In order of frequency of incidence, lingering memories of the event accounted for 38%, depression 28% and cardiac dysrhythmias 2% amongst others. Most of the 49 (88%) respondents that were psychological affected did not have any form of debriefing. Conclusion: Critical incident reporting should be encouraged, whilst anaesthetic departments should have departmental guidelines for managing the aftermath of critical incidents, and ensuring psychological support for their practitioners. Trainees should undergo a training module in psychological debriefing following critical incidents as part of their curriculum. Medical Defence Organizations should be established in developing countries with appropriate government legislation.

PTSD in South African anaesthetists after experiencing a death on the theatre table

“…9,[14][15][16] Although immediate debriefing is regarded as a beneficial intervention, it remains a rare occurrence, leaving the affected anaesthetist vulnerable to negative emotional responses. [17][18][19] Anaesthetists agree that time off after such an event should be offered. The amount of time off that is acceptable varies from one to two days, while some feel that a case-by-case approach should be followed.…”