126 Papers, Lectures at ASA Highlight Safety

John H. Eichhorn, M.D.

Patient safety will again be the topic of many presentations at the American Society of Anesthesiologists Annual Meeting, this year to be held in San Francisco October 15-19.

In the Refresher Course Lectures, Dr. Robert Caplan will give lecture # 151 Saturday, October 15 at 9:00 a.m. on ‘Adverse Outcomes in Anesthesia Practice’ and Dr. Fred Cheney will deliver lecture # 156 the same day at 4:30 p.m. on “The ASA Closed Claims Project: Lessons Learned.’ Both speakers are from Seattle and have been principle investigators in the ASA Closed Claims Study, which has contributed significantly to the understanding and improvement of anesthesia patient safety over the last several years.

126 papers in eight scientific sessions of the meeting comprise the section on Patient Safety, Epidemiology, and Education. There are five oral presentation sessions, two poster sessions, and one poster-discussion session.

Cost and Safety

12 presentations on Monday afternoon, October 17, deal with the implications of cost saving strategies in anesthesia practice. For example, Dr. A. Mathieu will present ‘Cost-minimization study confirms the safety and cost effectiveness of saving endotracheal tubes after violation of packaging for later usage.’

Blocks, CPR, and Videotape

Tuesday morning, October 18, Dr. S. Palmer will discuss ‘Complication rates for major regional blocks are different in general surgery compared to obstetrics’ while Dr. N. Jeffries will give a presentation revealing the ‘Incidence of procedural errors and critical occurrences associated with tracheal intubation assessed from videotapes and self reports.’ Dr. S. Glowacki will ask the highly charged question: ‘Can electrocautery transmission induce current in a pulmonary artery catheter?’ Other papers in this session will deal with aspects of difficult airway management, errors in CPR, effects of hypothermia, relationship of frequency of post-spinal headache to needle type, and reducing patient risk by doing gasless laparoscopy.

In the Tuesday afternoon oral presentation session, papers will cover postoperative hypoxemia associated with acute pain management guidelines, impact of various QA systems, and the risk factors for dental injury. Drs. L. Mark and C. Cherian win cover different aspects of the Medic Alert Difficult Airway/Intubation Registry.

Panoply of Posters

Tuesdays poster session will feature 30 presentations. Several deal with aspects of transfusion and blood conservation. Reuse of purportedly single use syringes will be covered. Another aspect of possible infection transmission to patients is included in a paper by Dr. A. Layton entitled, “Mycobacterial and pseudomonal contamination of C02 absorber: scrubbed but not clean.’ Safety features concerning catheterization of jugular veins as well as new considerations of malignant hyperthermia are also included.

Three poster presentations on anesthesia simulators are included in the Wednesday morning, October 19, poster session. Several more papers concerning safety and performance features of the laryngeal mask airway and its use are also components of this session. Fluoride ion toxicity from sevoflurane use is the subject of a poster and Dr. R. Marcel will present a poster on “Nocturnal hypoxemia following coronary artery bypass graft surgery.’ Dr. K Tuman’s contribution is ‘Effect of beta blocker and calcium channel blocker therapy on MI and death after CABG.’ The clinical significance of psychomotor impairment resulting from IV sedation WILL be considered by Dr. R. Thapar. Dr. Y. Wafai revisits the question of the value of the self-inflating bulb for the confirmation of correct tracheal intubation.

Oral presentations concerning anesthesia education will take place Wednesday afternoon. One paper examines the use of the critical incident technique in the performance evaluations of anesthesia residents while another will focus on anxiety and stress reduction among anesthesia residents. Teaching management of the difficult airway is the subject of one presentation. Dr. H. Schaefer concludes the session with a paper entitled, ‘Do pilots handle complexity and uncertainty better than anesthesiologists?”

Overall, the 126 papers represent another very strong showing for this section of the ASA annual meeting and ft reflects the ongoing interest in and emphasis on patient safety among anesthesiologists.

Dr. Eichhorn, Professor and Chairman of Anesthesiology at the University of Mississippi School of Medicine Medical Center, is Editor of the APSF Newsletter.