Volume 10, No. 3 • Fall 1995

Patient Safety Will Be Central Theme at ASA

John H. Eichhorn, M.D.

With extra special emphasis this year, patient safety will again be a major theme during the American Society of Anesthesiologists Annual Meeting in Atlanta from Saturday, October 21 through Wednesday, October 25.

Patient safety will receive additional particular attention because the keynote address of the over 20,000-person meeting, the Rovenstein Memorial Lecture, will be given by Ellison C. Pierce, Jr., M.D., President of the Anesthesia Patient Safety Foundation since its inception in the fall of 1985. Dr. Pierce’s title for his Monday lecture at 11:15 a.m. is “40 Years Behind the Mask: Safety Revisited.”

Yet even more emphasis on patient safety as a major theme of the meeting will occur this year because the other main named lectureship, the Lewis H. Wright Memorial Lecture, sponsored by the Wood Library-Museum of Anesthesiology, will be given by E.S. Siker, M.D., Executive Director of the Anesthesia Patient Safety Foundation. At 1:00 p.m. Tuesday in the Georgia World Congress Center main hall, Dr. Siker will speak on “Anesthesia Safety: An Evolution.”

139 Papers Scheduled

In the meeting section “Patient Safety, Epidemiology, History, and Education,” there will be 139 scientific presentations in a total of nine separate sessions.

Included in the 46th Annual Refresher Course Lecture Program on Saturday, October 21, will be a presentation on OR electrical and fire safety by Dr. Jan Ehrenwerth and also “Improved Anesthesia Care Through Computer Technology in the OR” by Dr. David Reich. The following day, Sunday, October 22, will see Dr. Jon Benumof offer an update on the application of the ASA Difficult Airway Algorithm and also a presentation from Dr. Robert Caplan, one of the architects of the ASA Closed Claims Project on “Adverse Outcomes in Anesthesia Practice.” A natural follow-up on Tuesday, October 24, will be a Clinical Update by Dr. Fred Cheney entitled: The ASA Closed Claims Project: Lessons Learned.

Three scientific sessions will have the widely popular “Poster-Discussion” format during which there will be 30 minutes for all interested attendees to study a relatively small number (e.g. ten) of posters followed by 60 minutes of interactive discussion involving both the authors and the audience, with two experts in the field to stimulate discussion. The Monday morning session on “Complications” deals with a variety of intra- and postoperative conditions and their association with anesthesia complications. The Tuesday afternoon session on “Patient Satisfaction; Postoperative Complications” will cover a variety of topics, including some on patient pain and anxiety. The Wednesday afternoon session on “Airway Management” will feature posters dealing with the incidence of difficult intubations, methods to confirm correct intubation, and even the influence of stress on the incidence of errors in airway management.

Two traditional poster sessions with relatively large numbers of presentations are scheduled. The Monday morning session on “Education; Cost Effectiveness; Patient Safety” will include a wide range of topics. Featured will be the New York remediation program as a model for retraining of practitioners, other education programs, several presentations concerning quality improvement applied to anesthesia care, and posters on the impact of cost-containment programs. The Wednesday morning poster session concerns “Patient Safety; Airway Management” and also spans a wide spectrum of topics. Complications associated with various medications as well as with vascular access procedures will be presented as well as follow-up work on the question of the appearance of carbon monoxide from absorbents. A poster on airway obstruction during sedation is scheduled as is one on the outcome following early extubation after cardiac surgery.

The oral paper presentations begin Monday morning with a session involving transfusion therapy and also malignant hyperthermia. Blood loss estimation, blood salvage, and hemodilution will be among the topics covered. The Tuesday morning session concerns resident education and there is a paper about using a computer simulation to measure resident fatigue as well as three other papers about fatigue and decreased performance, with obvious safety implications. Using videotaping as a teaching tool is the subject of two papers. Another Tuesday morning session covers “History and Education” in anesthesia. Finally, the Wednesday morning oral presentation session is on cost-effectiveness and includes several studies that directly address current questions, such as the safety of using endotracheal tubes days after they were opened but not used for another case. Other papers will deal with the relative costs of various medications, particularly the potent volatile anesthetics.

In all, it promises to be a landmark year for patient safety as a topic at the ASA meeting.

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