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Crisis management during regional anaesthesia.
M A L Fox1, R W Morris, W B Runciman
1Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia.
Quality & Safety in Health Care
|June 4, 2005
Summary
A structured algorithm effectively manages regional anesthesia complications. This approach aids in swift recognition and appropriate treatment of adverse events during anesthesia procedures.
Area of Science:
- Anesthesiology
- Patient Safety
- Clinical Algorithms
Background:
- Regional anesthesia is common but can lead to life-threatening complications.
- Prompt recognition and management are crucial for patient safety.
Purpose of the Study:
- To evaluate a core algorithm (COVER ABCD-A SWIFT CHECK) and a regional anesthesia sub-algorithm for managing complications.
- To assess the algorithm's performance in real-world incident reports.
Main Methods:
- Analysis of 252 regional anesthesia incidents from the Australian Incident Monitoring Study (AIMS).
- Assessed the applicability of the COVER ABCD-A SWIFT CHECK algorithm and a specific regional anesthesia sub-algorithm.
Main Results:
- Regional anesthesia incidents comprised 6.3% of all AIMS reports.
- The core algorithm could address 45% of problems; the sub-algorithm, 55%.
- Hypotension and dysrhythmias were major issues, contributing to all six deaths.
Conclusions:
- The combined algorithms facilitate rapid identification and management of regional anesthesia-related problems.
- Proper application of these algorithms can improve patient outcomes and safety.