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Keeping Patients Safe Under Anesthesia

Photos: Courtesy of the Patient Safety Movement Foundation

Anesthesiologists know all too well that the human body is complex and that there’s no such thing as a routine surgery when anesthetics are involved. Though advancements in medications and technology are making a difference, medical errors still happen, and medication-related errors — wrong drug, wrong dose, or wrong route of administration — are one of the leading causes of death in the healthcare system.

Against the popular belief that the majority of medication-related errors occur during late-night shifts, one study found that this is not the case. A few of the daily challenges that all anesthesiologists face include fatigue, lack of staff, odd working hours and poor communication. However, anesthesiologists have taken on a leadership role in advocating for patient safety, and their efforts have produced remarkable results.

Reducing harm

Over the past five decades, the rate of harm for patients undergoing surgery has dropped to one-tenth of what it was prior to 1970. To take these gains outside the operating room, the Patient Safety Movement Foundation works with thousands of anesthesiologists around the world. We partner with organizations including the American Society of Anesthesiology, the Anesthesia Patient Safety Foundation, the European Society of Anesthesiology and the World Federation of Societies of Anesthesiologists, to work toward our goal of eliminating all preventable patient deaths by 2020. We are not simply hoping for zero. With our partners, we are planning for it by creating actionable patient safety solutions (APSS) — we have 13 now — and asking all hospitals to implement them.

With this information, patients and their loved ones can ask their anesthesiologist and medical care team to adhere to the 13 APSS. To make this process easy, we have developed a mobile app called PatientAider that walks patients through potential challenges and their solutions. The app also tells the patient which questions they or their loved ones should ask before, during and after surgery.

How to think about pain

While no one wants to experience unnecessary discomfort, patients need to understand that asking for “zero pain” is not always the safest option. A certain degree of pain is normal after surgery and should be tolerated, which is why patients should base their satisfaction scores on outcomes, not the degree of discomfort felt after the surgery.

Painkillers come with their own risks. For example, if a patient is put on too high an amount of opioids, they can cross the fine line from having no pain to having no breath. If proper precautions aren’t taken, a patient can make it through a complicated surgery only to be found dead in bed due to the opioids used to control pain. (In an instance where a patient requests opioids, they should be monitored so if they stop breathing, nearby clinicians can be notified.)

At the end of the day, the future of anesthesiology is clear: Make the rest of the hospitals as safe as the operating room, and make the operating room even safer. 

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