Patient safety will again play a major role at the upcoming Annual Meeting of the American Society of Anesthesiologists, which will be held in Orlando, Florida, October 12-16, 2002. The meeting kicks off Saturday morning with a number of safety-related Refresher Course Lectures including Dr. Klock discussing Drug Interactions for the Anesthesiologist (#111), Dr. Gilbert presenting Complications and Controversies in Regional Anesthesia (#123), Dr. Berry reviewing What to Do After a Bad Outcome (#142), Dr. Barker highlighting Recent Developments in Oxygen Monitoring (#171), and Dr. Cottrell advising on Brain Protection in Neurosurgery (#172). The afternoon session continues with Dr. Ellis discussing Myocardial Ischemia and Postoperative Management (#134), Dr. Eichhorn providing counsel on Risk Management in Anesthesia (#136), and Dr. Hines giving an update on Substance Abuse in Anesthesia Providers (#164). Also at this session Dr. Eisenkraft will share Problems with Anesthesia Gas Delivery Systems (#166) while Dr. Caplan will review ever important lessons learned from the ASA Closed Claims Project (#175). The afternoon session is rounded out by Dr. Leak elucidating The Potential Hazards of Perioperative Herb and Supplement Use (#176).
The Refresher course lectures resume on Sunday morning, October 13, with many more safety-related topics including Dr. Ruskin reviewing Techniques for Rapidly Retrieving Accurate Electronic Clinical Information (#221). Several topics address monitoring modalities and include Dr. Mark helping us to be sure we are Getting the Most from a CVP Catheter (#231), Dr. Aronson expounding on the Role of Transesophageal Echocardiography in Noncardiac Surgery (#232), and Dr. Barash discussing the Sequential Monitoring of Myocardial Ischemia in the Perioperative Period (#233). Morning sessions also include Dr. Cook exploring Friend and Foe: Why We Can’t Agree About the Effects of New Technology on Patient Safety (#251) and Dr. Rosenberg keeping us up to date on Malignant Hyperthermia: The Disease of Anesthesia (#272). Sunday afternoon Refresher Courses lectures are also replete with safety-related topics including Dr. Sebel insuring anesthesiologists’ awareness of patient Awareness During General Anesthesia (#225) and Dr. Ehrenwerth presenting the hot topic of Fire Safety in the Operating Room (#226). Airway topics are also planned and include Dr. Benumof linking Obesity, Sleep Apnea, the Airway and Anesthesia (#234) and Dr. Hall highlighting The Child with a Difficult Airway: Recognition and Management (#246). Other topics include Dr. Andrews presenting Understanding Your Anesthesia Machine (#254), Dr. Stoelting reviewing NPO and Aspiration: New Perspectives (#274), and finally, Dr. Warner providing important information on Perioperative Neuropathies, Blindness and Positioning Problems (#276).
Rovenstine Lecture Will Focus on Development of Sedation Guidelines
The annual Rovenstine Memorial Lecture will be held on Monday, October 14, 2002 from 11:30 a.m. until 12:15 p.m., at the Orange County Convention Center Auditorium. The extension of patient safety outside of the operating room will be evident when Dr. Burton S. Epstein, Professor Emeritus in Anesthesiology and Pediatrics from the George Washington University School of Medicine, presents the 41st Annual Rovenstine Memorial Lecture, entitled “ASA’s Efforts in Developing Guidelines for Sedation and Analgesia for Nonanesthesiologists.” Dr. Epstein will be introduced by Barry M. Glazer, MD, outgoing ASA President.
Patient Safety Prominent at Poster Sessions
This year’s ASA features a plethora of scientific papers that address many safety-related topics, beginning on Monday, October 14 at 9:00 a.m. in Room 224 D of the Convention Center. In a session moderated by Drs. Furman and Johnston, Dr. Norton and colleagues will question if the FDA’s droperidol warning is justified (A-1196), and Dr. Harwood will relate patient dissatisfaction to undesired outcomes and poor patient-provider communication (A-1190). Drs. Bready and Cook will also moderate a session in Area H from 9 to 11 a.m. in which Dr. Rozner will present two papers discussing perioperative pacemaker management (A-1070 and A-1071), and Dr. Nunnally and colleagues will review reports of infusion device related incidents (A-1073). This forum also includes Dr. Andeweg’s team presenting a patient simulator model evaluating rescue capability after critical events occurring with pediatric sedation (A-1074), as well as the importance of perioperative beta-blockade, which will be emphasized by Dr. Rapchuk’s team (A-1078).
Several papers in this session focus on airway management and include an examination of the sniffing position (A-1080) and the impact of positioning on preoxygenation of morbidly obese patients (A-1088). An endoscopic study of laryngeal structures that obstruct the smooth passage of the endotracheal tube during fiberoptic intubation (A-1087), and an analysis of the association of radiotherapy with difficult direct laryngoscopy and fiberoptic intubation (A-1084) will also be presented along with a comparison of the patientÕs height to thyromental distance as a predictor of difficult laryngoscopy (A-1085).
Diverse Topics Abound
A group from the Mayo Clinic will discuss the effect of the lithotomy position on obturator and lateral femoral cutaneous nerve strain (A-1076), and Dr. Holak and colleagues will present a frightening report of an anesthesia machine explosion and fire occurring due to a combination of high minute ventilation, dry absorbent and high carbon monoxide concentrations (A-1081). In addition, a Chicago-based group led by Dr. Roth examines the safety and problems associated with needle retractable intravenous catheters (A-1098). That same afternoon, in Area G, Drs. Mackey and Sweitzer will moderate an extensive session that includes a number of presentations associated with patient safety including Dr. Rocchiccioli’s presentation of patients with obstructive sleep apnea and the influence of anesthetic technique on perioperative morbidity (A-1133). An analysis of sentinel events related to medication errors is provided by R. Bengal and her team (A-1153), and a group from Albert Einstein College of Medicine discuss the use of human errors as a measure of competency (A-1154). Clinical performance factors during pediatric sedation will also be presented by Dr. Sowb’s group from Palo Alto, California (A-1159).
Safety presentations continue on Tuesday morning, October 15 in room 224 C, where Drs. Rosenberg and O’Conner moderate a session devoted largely to malignant hyperthermia and succinylcholine induced hyperkalemia. Presentations A-1198 through A-1205 include a review of the history of malignant hyperthermia, a reassessment of the safety and efficacy of dantrolene, alternative in vitro contracture testing methods, a survey of chronic muscle pain and associated symptoms in MH-susceptible individuals, and the impact of 4 different pretreatment methods on succinylcholine induced hyperkalemia.
Closed Claims Analyses Anticipated
Parallel sessions also held Tuesday morning from 9 a.m. to 12 p.m. in Area E, will be moderated by Dr. Lineberger and Dr. Curry. The ASA Closed Claims project provides the basis for an analysis of injuries related to central lines, which is presented by Dr. Spitellie and colleagues from the University of Washington (A-1124). The Closed Claims Project is also cited by Dr. Lee’s team in an analysis of claims associated with regional anesthesia between 1980 and 1999 (A-1126). A decrease in emergent reintubation following the establishment of a standard for monitoring and documenting reversal of neuromuscular blockade will also be presented by Dr. Freund and coworkers (A-1125). This meeting also includes a sobering look at anesthesiologist longevity and mortality which will be presented by a group from Yale University (A-1105) and reminds us of provider, as well as patient safety. Finally, Drs. Calmes and Bacon will moderate a 3rd session, Tuesday morning, in Area F which includes a discussion of human errors and physicians’ ability to learn from their mistakes (A-1179), and Dr. Halaszynski’s group from Yale will present information on sequelae associated with subarachnoid catheter placement (A-1175).