Robert C. Morell, MD, Editor, APSF Newsletter

The spring 2006 issue of the Anesthesia Patient Safety Foundation (APSF) Newsletter marked its 20th year of publication, with the Newsletter now recognized as having the largest circulation of any anesthesia publication in the world. As this Newsletter reaches its 80,530 readers, I call attention to Volume 1, Number 1, published in the spring of 1986. This landmark issue included an article that addressed why the APSF was organized, announced that the APSF would fund and award grants for research in patient safety, explored the question of minimal essential monitoring, and listed initial founding officers, directors, and committees. It was 8 pages in length.

Over the past 20 years the APSF Newsletter has grown and matured, first under the editorship of Dr. John Eichhorn (1986-2002) and currently under my direction (2002-Present). During the 16 years with Dr. Eichhorn as editor, the now widely known story of the dramatic improvement in anesthesia patient safety unfolded and was chronicled quarterly in the APSF Newsletter, along with an abundance of breaking news and controversial issues. The promulgation and implementation of monitoring and other anesthesia practice standards were frequent early, then recurrent, topics. The ASA Closed Claims Study was outlined initially and then covered episodically, including recent coverage of the timely topic of postoperative visual loss. The FDA equipment checkout protocol was introduced to the anesthesia community. A multitude of presentations, exhibits, and technology displays at a wide variety of meetings, as well as groundbreaking publications of many kinds, have been reported on since the earliest issues. Debates on fatigue, work hours, and provider impairment appeared periodically. Medication errors due to inconsistent drug packaging have been a recurrent theme throughout the Newsletter’s existence. The potential huge role of sophisticated simulators in anesthesia training was first touted in these pages and also was one of many subjects reviewed as topics of grant research funded by APSF. Recently, the value of anesthesia information systems has been highlighted and the Data Dictionary Task Force continues to provide an infrastructure to facilitate the utility and cross compatibility of AIM systems, a development that will greatly expedite outcomes research. Among the “breaking news” items were CO production by carbon dioxide absorbents in certain situations, danger from succinylcholine in children, 5% lidocaine in spinals, reuse of disposables, overly aggressive liposuction, poorly organized office-based anesthesia care, and sulfites in generic propofol. Still more recent hot topics included fires and explosions from overheated carbon dioxide absorbers, a recall of contaminated sevoflurane, post-anesthesia blindness, decrements in cognitive function, and a variety of equipment issues (such as gas pipeline problems), and human factors discussions (such as production and cost pressures as well as reading in the OR).

During the last few years a number of exciting initiatives have been added to the Newsletter’s content, which is now produced in color. These initiatives include the Dear SIRS column (developed by Dr. Michael Olympio and Dr. Robert Morell), and the Q and A column (inspired by Dr. Stoelting and developed by Dr. Olympio and the Committee on Technology), both of which appear in each issue of the Newsletter and address important technology queries brought to our attention by our readers. The Dear SIRS feature is quite unique in that technology-based queries are addressed by manufacturers and industry representatives, along with Dr. Olympio and members of his committee. The exchange of information and response to reader questions help to disseminate technology based safety concerns and provide a line of communication between the clinician and industry. It truly has been a win-win initiative.

The latest initiative is the new partnership between the APSF and the journal Anesthesia & Analgesia (A&A). Tremendous gratitude is extended to Dr. Steve Shafer, editor of A&A, for his vision and enthusiasm in forging this cooperative venture as A&A becomes the official scientific journal of the APSF. Similarly, appreciation is expressed to the Board of Trustees of the International Anesthesia Research Society for their support of this endeavor. Coincident with this joint venture is the establishment of a new section on patient safety within A&A, of which Dr. Sorin Brull has been selected the new section editor.

The APSF Editorial Board continues support of the Newsletter and its editor with creative, hardworking individuals who provide critical reviews, feedback, and fresh ideas while frequently contributing to the Newsletter’s content. Drs. Murphy, Vender, and Greenberg continue to review scientific abstracts presented at the annual ASA meeting, Drs. Lee and Posner have contributed several important articles including cutting-edge news on postoperative visual loss and important messages from the closed claims database; Dr. Eichhorn shares his depth and breadth of experience and continues to contribute articles including the annual review of ASA scientific and commercial exhibits; Dr. Christie is our liaison with the annual APSF booth and is highly creative in sharing ideas for new articles and initiatives. Ms. O’Brien is our liaison with the American Society of PeriAnesthesia Nurses (ASPAN) and has extensive editorial experience herself. Dr. Jan Ehrenwerth is a source of tremendous knowledge and experience in patient safety and helps us keep our direction and focus on track. Rodney Lester, CRNA, PhD, is past president of the American Association of Nurse Anesthetists and is a willing and enthusiastic contributor. Dr. Sorin Brull is chair of the APSF Scientific Evaluation Committee and tirelessly keeps our grant announcements up-to-date while authoring the extensive reviews of our annual grant award recipients and their proposals. As previously mentioned, Dr. Brull has recently received the honor of being selected the first section editor of patient safety for the journal Anesthesia & Analgesia. I would also like to personally express my appreciation and gratitude to Wilson Somerville, PhD, for his tireless efforts as he reads and rereads each and every word of each issue of this Newsletter, insuring quality, accuracy, and clarity. His expertise as a medical editor and his friendship and support are invaluable. Ms. Addie Larimore is the glue that holds all of this together as the Newsletter evolves from rough copy, through formatting and editing, to final production. Her organizational and editorial skills are outstanding and exceeded only by her patience. The APSF is truly fortunate to have the production and publication support of Bonnie Burkert and her colleagues at GrafikPharm. Through her efforts we continue to improve our appearance, our processes, influence, and appeal to our readership. Finally, our most valuable asset is our readership. Without the support and input (letters, questions, queries, criticism, suggestions, ideas and articles) of our readers this Newsletter would be mere words on a page.

Dr. Morell is editor of this newsletter, Clinical Associate Professor of Anesthesiology, Wake Forest University Health Sciences, Winston-Salem, NC, and Adjunct Clinical Associate Professor of Anesthesiology, University of Florida School of Medicine, Gainesville, FL. Dr. Morell is in the private practice of anesthesiology and resides in Niceville, FL.