naa a22 4500 510744397 CHVBK 20180411083040.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12630-012-9852-z doi (NATIONALLICENCE)springer-10.1007/s12630-012-9852-z Eichhorn John Department of Anesthesiology, College of Medicine, University of Kentucky, N-202, UKMC, 800 Rose St., 40536-0293, Lexington, KY, USA aut Review article: Practical current issues in perioperative patient safety [Elektronische Daten] [John Eichhorn] Article de synthèse: Problèmes pratiques actuels pour la sécurité périopératoire des patients Purpose: This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. Principal findings: The dramatic improvement in anesthesia patient safety over the last 30years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring” that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia”. Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power”), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Conclusions: Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient safety. Canadian Anesthesiologists' Society, 2012 Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/2(2013-02-01), 111-118 0832-610X 60:2<111 2013 60 12630 https://doi.org/10.1007/s12630-012-9852-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9852-z text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Eichhorn John Department of Anesthesiology, College of Medicine, University of Kentucky, N-202, UKMC, 800 Rose St., 40536-0293, Lexington, KY, USA aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/2(2013-02-01), 111-118 0832-610X 60:2<111 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer