World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia

Gelb, Adrian W.; Morriss, Wayne W.; Johnson, Walter D.; Merry, Alan

doi:10.1007/s12630-018-1111-5

Cited by 127 publications

(109 citation statements)

References 7 publications

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“…Two investigators checked the anesthesia personnel, monitoring, and delivery technique in the department according to the ISSPA [8]. The ISSPA includes three levels of standards: highly recommended, recommended, and suggested standards.…”

Section: Methodsmentioning

confidence: 99%

“…To provide guidance and assistance in maintaining and improving the quality and safety of anesthesia care worldwide, the International Standards for a Safe Practice of Anesthesia (ISSPA) was developed on behalf of the World Federation of Societies of Anaesthesiologists and the World Health Organization [8]. The ISSPA was first published in 1992 and most recently amended in 2018.…”

Section: Introductionmentioning

confidence: 99%

“…The ISSPA was first published in 1992 and most recently amended in 2018. The ISSPA covers essential areas for anesthesia safety, including professional aspects, facilities and equipment, medications, monitoring, and the conduct of anesthesia [8]. The ISSPA has been recommend as an assessment tool that allows anesthetic departments, institutions, or countries to assess their compliance and needs [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The ISSPA covers essential areas for anesthesia safety, including professional aspects, facilities and equipment, medications, monitoring, and the conduct of anesthesia [8]. The ISSPA has been recommend as an assessment tool that allows anesthetic departments, institutions, or countries to assess their compliance and needs [8,9]. In the present study, we described the anesthetic management in one of the largest teaching institutions in Phnom Phen, Cambodia for the first time and evaluated its anesthetic safety issues according to the ISSPA.…”

Section: Introductionmentioning

confidence: 99%

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The challenge of safe anesthesia in developing countries: defining the problems in a medical center in Cambodia

Tao

Sokha²,

Yuan

2020

BMC Health Serv Res

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Background: The International Standards for a Safe Practice of Anesthesia (ISSPA) were developed on behalf of the World Federation of Societies of Anaesthesiologists and the World Health Organization. It has been recommend as an assessment tool that allows anesthetic providers in developing countries to assess their compliance and needs. This study was performed to describe the anesthesia service in one main public hospital during an 8-month medical mission in Cambodia and evaluate its anesthetic safety issues according to the ISSPA. Methods: We conduct a retrospective study involving 1953 patients at the Preah Ket Mealea hospital. Patient demographics, anesthetic techniques, and complications were reviewed according to the registers of the anesthetic services and questionnaires. The inadequacies in personnel, facilities, equipment, medications, and conduct of anesthesia drugs were recorded using a checklist based on the ISSPA.Results: A total of 1792 patients received general and regional anesthesia in the operating room, while 161 patients receiving sedation for gastroscopy. The patients' mean age was 45.0 ± 16.6 years (range, 17-87 years). The three most common surgical procedures were abdominal (52.0%; confidence interval [CI], 49.3-54.7), orthopedic (27.6%; CI, 25.2-29.9), and urological surgery (14.7%; CI,). General anesthesia, spinal anesthesia, and brachial plexus block were performed in 54.3% (CI, 51.7-56.8), 28.2% (CI, 25.9-30.5), and 9.4% (CI, 7.9-10.9) of patients, respectively. One death occurred. Twenty-six items related to professional aspects, monitoring, and conduct of anesthesia did not meet the ISSPA-recommended standards. A lack of commonly used drugs and monitoring equipment was noted, posing major threats to the safety of anesthesia practice, especially in emergency situations. Conclusions:This study adds to the scarce literature on anesthesia practice in low-and middle-income countries such as Cambodia. Future medical assistance should help to strengthen these countries' inadequacies, allowing for the adoption of international standards for the safe practice of anesthesia.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The challenge of safe anesthesia in developing countries: defining the problems in a medical center in Cambodia

Tao

Sokha²,

Yuan

2020

BMC Health Serv Res

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“…It is a mistake to conflate the policy ambitions of Disease Control Priorities (Third Edition), 3 the Lancet Commission on Global Surgery, 4 the World Health Assembly resolution 68.15, 5 and the United Nations Sustainable Development Goals, 6 with our comments on the recently published World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for the Practice of Safe Anesthesia. 2,7 We believe that there are two lenses through which one may analyze the role of international standards for anesthesia.…”

Section: To the Editormentioning

confidence: 99%

In Reply: Comment on “Encouraging a bare minimum while striving for the gold standard: a response to the updated WHO-WFSA guidelines”

Hendel

Banguti

Workneh

et al. 2018

Can J Anesth/J Can Anesth

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The Single-Clinician–Operator/Anesthetist Model for Dental Deep Sedation/Anesthesia

2019

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In the June issue of Pediatrics, 1 the American Academy of Pediatrics (AAP) published a joint statement with the American Academy of Pediatric Dentistry updating the 2016 AAP sedation guideline. 2 This statement contains strong wording concerning the need for an independent, skilled professional to manage children during deep sedation in the dental setting. It is essential for pediatricians and family practitioners to understand why this document was revised. The guideline reiterates the need for an appropriate history and physical examination, including a focused airway examination. For highrisk patients (eg, syndromic children or serious health issues), consultation with an anesthesiologist or other specialist is suggested. It provides a list of ageappropriate and size-appropriate equipment; resuscitation drugs and other sedation basics, including opioid and benzodiazepine antagonists; and decision algorithms for the management of airway obstruction, laryngospasm, and apnea. Oxygen saturation, expired carbon dioxide, heart rate, and other parameters are documented on a time-based record. Both the independent observer and the dental clinician must be up to date with Pediatric Advanced Life Support (PALS) or Advanced Pediatric Life Support certification.In March 2015, a healthy 6-year-old boy received deep sedation for removal of a supernumerary tooth; after multiple sedating medications, he developed apnea and airway obstruction. The oral surgeon was unable to clear the airway, and there was no other skilled help in the office. Caleb was in full cardiac arrest when the emergency medical technicians arrived, and he died from his hypoxic event.Caleb's aunt, Anna Kaplan, now a pediatric resident, worked diligently to introduce legislation that required an anesthesia-trained professional for deep sedation/anesthesia for children, but Assembly Bill 2235, known as Caleb's Law, 3 was withdrawn owing to the wellfunded oral surgery lobby. 4 Instead, the California legislature codified the single-clinician-operator/ anesthetist model for oral surgeons, whereby the operating dentist/oral surgeon can simultaneously provide deep sedation/anesthesia and perform the dental procedure (2 tasks concurrently) and bill the patient or family for both.This law is of national importance because their success in California has encouraged oral surgeons in other states to propose similar legislation. The single-clinicianoperator/anesthetist model supported in these laws is in contradistinction to all known anesthesia standards of the modern medical community, including the World Health Organization, the American Society of Anesthesiologists, the Society for Pediatric Sedation, the

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World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia

Cited by 127 publications

References 7 publications

The challenge of safe anesthesia in developing countries: defining the problems in a medical center in Cambodia

The challenge of safe anesthesia in developing countries: defining the problems in a medical center in Cambodia

In Reply: Comment on “Encouraging a bare minimum while striving for the gold standard: a response to the updated WHO-WFSA guidelines”

The Single-Clinician–Operator/Anesthetist Model for Dental Deep Sedation/Anesthesia

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