As the 1990s wind down, patient safety does not, and the last Annual Meeting of the American Society of Anesthesiologists before Y2K (October 9-13 in Dallas) again will feature various presentations concerning anesthesia patient safety issues.
In the Refresher Course Lectures, Dr. R. Caplan presents “The ASA Closed Claims Project: Lessons Learned” on Saturday morning (Lecture # 121) and he is followed by Dr. M. Warner covering “Perioperative Neuropathies: Etiology, Prevention, and Medicolegal Consequences” (#122). Later, during Saturday afternoon, Dr. J. Benumof will provide an update entitled “The ASA Difficult Airway Algorithm: New Thoughts/Considerations (#134), and Dr. C. McLeskey will speak on “Awareness During Anesthesia (# 115). Also Saturday morning will be Dr. B. Gutsche on “How to Make an Epidural Safe and Effective (#142) and Dr. S. Palmer on “Anesthetic Management of Obstetric Emergencies” (#143). On Sunday, Dr. R. Stoelting will lecture on “NPO and Aspiration: New Perspectives” (224) and Dr. J. Eichhorn will summarize many patient safety related topics in a presentation of “Risk Management in Anesthesia” (# 253).
Among the Panel Discussions, on Tuesday afternoon, there will be a five-speaker panel on “Ideas for Office-Based Anesthesia” that will cover several specific safety issues. Likewise, regarding another hot and resurgent topic, Wednesday morning will occur a panel presentation concerning “Fire in the Operating Room: Still a Problem.”
In the three sessions of the “Scientific Papers” part of the program, there will be 63 papers presented.
In the Monday morning poster session (Convention Center Hall B-D, Room F), Dr. A Zavrski from Austria will present “Sevoflurane versus midazolam for conscious sedation in patients undergoing elective procedures: safety results” (abstract #1163). Dr. H. Rosenberg’s topic is “Changing patterns of cardiac arrest/death from malignant hyperthermia” (1166). “The incidence of herbal and selected nutraceutical use in surgical patients” (1168), a likely first among ASA meeting topics will be presented by Dr. C. McLeskey. Dr. H. Wissing from Germany will attempt to answer the question “Does the amount of dry soda lime affect carbon monoxide production with desflurane?” (1170) while Dr. H. Forster (also from Germany) addresses “The formation of fluoride in desiccated carbon dioxide absorbents during gassing with sevoflurane” (1176). Possibly corresponding to the remarkable number of warming devices expected to be on display in the Technical Exhibits, Dr. J. Berry will present “Postoperative hypothermia in a tertiary care hospital” (1177) and Dr. T. Matsukawa from Japan will also present “Exaggerated perioperative hypothermia in elderly surgical patients” (1181). Dr. L. Fleisher and associates have a poster from an epidemiologic study entitled “Readmission and death after outpatient surgery as a function of location of care: analysis of 149,430 Medicare cases” (1183). Finally, a presentation with obvious patient safety implications and a title reminiscent of the classic critical incident studies of 20 years ago, “Prevention of cardiac arrest and death during transport of patients from the operating room: a systems analysis of critical errors” (1189) will be presented by Dr. J. Rosenberg and colleagues.
Components of the Tuesday morning poster session (same location) include: “Perioperative warming reduces bacterial proliferation on endo-vascular grafts in dogs” (1191) by Dr. P. Alfonsi from France; “Superior emergence from anesthesia in the prone versus supine position in patients undergoing lumbar surgery” (1194) by Dr. M. Olympio; and “Transfer of anesthesia care and adverse outcome” (1196) by Dr. V. Joseph. Finally, a meta-analysis of epidemiologic techniques will be presented by Dr. P. Barach in a poster “In-depth study of 30 major incident reporting systems with a focus on near-miss reporting in medical, aviation, nuclear power, and petrochemical industries” (1209).
The Wednesday morning poster-discussion session (Convention Center, Room D-262,264) offers extensive audience participation as well as expert critiques of several highlighted presentations. Dr. L. Davies from the University of Florida will present “Postoperative cognitive dysfunction in the elderly following cardiopulmonary bypass” (1122) and Dr. M. Warner will continue the series of related Mayo Clinic papers with “Lower extremity neuropathies and the lithotomy position” (1123). Also from Mayo Clinic will be Dr. J. Abenstein presenting “Anesthesia outcome and its economic implications” (1125). Dr. R. Greif of UC San Francisco plans a poster declaring “Supplemental perioperative oxygen halves the incidence of surgical wound infection” (1127).
This listing merely scratches the surface of a rich panoply of options available and is only a partial preview of presentations at the ASA meeting concerned with anesthesia patient safety. Consult the meeting program for a complete inventory and further details.
Dr. Eichhorn, Chairman of Anesthesiology at the University of Mississippi, is Editor of the APSF Newsletter.