Keywords : guidelines
A retrospective study of critical incidents during anaesthesia in a tertiary care government hospital
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 828-835
Introduction: Patient safety is the primary objective of health care. Success and failures are part of it. Adverse events can be controlled but cannot be eliminated. They should be reported, documented, and studied. Such data is important to monitor hospital performance and also they serve as a medium for training, simulation and improvement in standards of anaesthesia care.
Material and method: An observational retrospective study was conducted in a teaching tertiary level government hospital from patient records who underwent adverse events or deaths related to anaesthesia over one year from October 2016 to September 2017. Type of adverse events and their relation to ASA grading, type and speciality of operation, age, sex and comorbidities of the patient, time of critical incident when occurred with relation to anaesthesia were analysed. Mortality was included as a critical event in our study and analysed.
Results: Critical events were documented in 50 patients (0.5%), with mortality 54%, while rest recovered completely. Highest number were documented in age group 31 to 50 years (26%) and ASA III patients(50%). Critical incidences happened more with emergency surgeries (52%), in patients with single preoperative comorbidity(35) and under general anaesthesia(78%) in maintenance phase(32.8%). Highest cause of mortality was related to cardiovascular and respiratory events.
Conclusion: Morbidity and critical events will always be part of anaesthesia practice. They might be prevented with proper vigilance. When they happen, it should be reported without fear of punitive results. They should be studied and analysed, and proper protocols and checklists should be developed according to local guidelines and medical practices. Such studies are important part of medical education process and improve patient care.