Volume 4, No. 2 • Summer 1989

Teaching Safety While in Touch with the Patient

E.C. Pierce, M.D.

In the last several years, anesthesia resident training programs have begun to examine their responsibility for teaching patient safety, risk management, and quality assurance. In fact, at the 1987 ASA Annual Meeting, a workshop on Education in Anesthesiology evaluated a program entitled “What Should Residency Training Programs be doing in the Patient Safety, Risk Management and Quality Assurance Field?” Panelist Ellison Pierce, Richard Ward and Stephanie Duberman examined several aspects of the question, including what some of the more well known programs currently provide and approaches residents may utilize to meet QA requirements.

In this issue of the APSF Newsletter Rick Siker, a long-time anesthesia residency program director and past president of both the American Board of Anesthesiology and the American Society of Anesthesiologists, describes “A Safety Tutorial”. Dr. Siker is certainly correct in his assessment and clearly reflects views of the other members of the Anesthesia Patient Safety Foundation who serve with him on the Executive Committee

Along the same lines, I offer the following quotation from a British anaesthetist, “My American experience has also firmly convinced me of the value of the noninvasive techniques of continuous monitoring via an esophageal stethoscope and pulse oximetry, techniques seldom used in Britain. I have also learned from the use of “high tech” monitoring facilities, generally unavailable in the U.K. because of cost, such as transesophageal echocardiography and pulmonary artery oximetry. However, an American could learn much from his British colleague with respect to contact with the actual patient. I have seen patients in the United States with eyes covered by plastic tape to protect against the ultraviolet fiats and then the head placed in a plastic bag to prevent heat loss; the patient vanishes. I seldom see the United States resident palpate the pulse, examine the conjunctiva, feel the skin, or look at the pupil.(1)”

E.C. Pierce, M.D.

President, Anesthesia Patient Safety Foundation


  1. Sebel, PS: Transatlantic lessons: one man’s view. Anesth Anals 1987;66:800