Volume 10, No. 2 • Summer 1995

Recurrent Issues Prompt Call for Continued Effort

Ellison C. Pierce, Jr., M.D.

Recently two anesthesia patient safety considerations have resurfaced.

The first has appeared in “Letters to the Editor” column in this Newsletter concerning anesthesia practitioners reading in the operating room while administering anesthetics. Certainly an anesthesiologist of my vintage, forty years of practice, rigidly proscribes reading during a case. I concur with the thoughtful letters in the negative found in the Spring APSF Newsletter.

I will point out, however, that Nik Gravenstein, M.D., one of the wisest persons I have ever known, does not completely agree. In his view, reading about the actual case under way, in order to deal with management problems, is reasonable. This would include textbooks, current articles, and anesthesia information systems. He believes that such reading may well lead to better anesthesia outcomes. Certainly he does not approve of anesthesia providers reading extraneous materials such as newspapers, financial reports, and novels.

The other issue that I thought had disappeared, following the establishment of the ASA Standards for Basic Anesthetic Monitoring several years ago, is the failure of the anesthesia provider to remain full time in the operating room continuously throughout the case taking care of the patient. Once more, it has come to my attention that in some practices, unfortunately, the anesthesia practitioner goes out of the operating room, leaving an anesthetized patient unattended, Anecdotal evidence suggests that in the last year, at least two patients have suffered cardiac arrest while the anesthesiologist was out of the room. I have been told that such situations may result in criminal prosecution of the practitioners.

Let us all work to continue the march forward of anesthesia patient safety in all arenas, including these two in particular.

Ellison C. Pierce, Jr., M.D. President, APSF