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[Quality and safe anesthesia for all children : That is their right!]
Markus Weiss1, Andreas Machotta2
1Anästhesieabteilung, Universitäts-Kinderspital, Steinwiesstraße 75, 8032, Zürich, Schweiz. weissmmd@aol.com.
Der Anaesthesist
|March 29, 2022
Summary
Children deserve the highest standard of health, including specialized pediatric anesthesia. Current practices in German-speaking countries fall short, leading to higher risks and mortality for pediatric anesthesia patients.
Area of Science:
- Pediatric Anesthesia
- Healthcare Quality
- Child Health Rights
Background:
- The United Nations Convention on the Rights of the Child (UNCRC) mandates the highest attainable standard of health for children.
- Safe Anesthesia for Every Tot (SAFETOTS) derived 10 Rights for pediatric anesthetic practice, emphasizing experienced providers for young children.
- Current pediatric anesthesia care in Germany, Austria, and Switzerland often fails to meet UNCRC standards, with higher complication and mortality rates than in adults.
Purpose of the Study:
- To highlight the critical need for specialized pediatric anesthesia to ensure children receive the highest attainable standard of health.
- To advocate for changes in healthcare policy and hospital financing to prioritize quality over performance in pediatric anesthesia.
- To emphasize the importance of experienced pediatric anesthesiologists and specialized centers for complex pediatric interventions.
Main Methods:
- Analysis of the UNCRC and SAFETOTS' 10 Rights concerning pediatric anesthesia.
- Review of the current state of pediatric anesthesia care in Germany, Austria, and Switzerland.
- Discussion of anesthesia-related complication and mortality rates in children compared to adults.
Main Results:
- Anesthesia-related complications are approximately 10 times more frequent in children than adults.
- Severe complications in pediatric anesthesia have a significantly higher mortality rate than in adult anesthesia.
- Many anesthesiologists lack sufficient child-specific expertise, leading to preventable morbidity and mortality, especially in centers with low case volumes.
Conclusions:
- Urgent changes are needed to guarantee children's right to the highest attainable standard of health in anesthesia care.
- Healthcare decision-makers and politicians must implement UNCRC standards, shifting from 'pay for performance' to 'pay for quality'.
- Complex pediatric treatments, especially for neonates, infants, and critically ill children, should be concentrated in specialized pediatric centers with dedicated teams.
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