Abstract
Introduction: A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty. Aim: In this audit, we aimed to report critical incident and near misses during conduct of obstetric anesthesia over a period of two years. Methodology: Critical incident forms were collected, entered, analyzed and categorized on the basis of American Standards Association (ASA), phase of incidents, system involved, and type of errors, outcome and action taken. Human error was further categorized on the basis of their contributing factor marked in form. Results: During the reporting period, 5511 anaesthetics were administered and 55 reports were received out of which 53 reports were included in analysis. Fifty three reports were divided into 33 critical incidents and 20 near misses. Out of 33 critical incidents, 54.5% involved CVS system and musculoskeletal system, followed by neuromuscular (n = 5), drug related (n = 4), airway/respiratory system (n = 2), central nervous system (n = 2) and renal system (n = 1). Forty five incidents possess no untoward effect while 7 led to minor and only one to severe physiological disturbance. Human errors were (n = 30) 57% reports and failure to check was the main contributory factor. Conclusion: Critical incidents reporting needs to be introduced in sub-specialties at departmental, national and international level. Checking of equipment, medication and anesthesia machine must be part of regular checks in elective and emergency cases.
Highlights
A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty
Aim: In this audit, we aimed to report critical incident and near misses during conduct of obstetric anesthesia over a period of two years
It needs to be incorporated in our set up as well and as a first step, we start critical incident reporting in labor room suite where twenty four hours anesthesia services are available for one elective, one emergency theatre and labor room epidurals
Summary
A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty. Aim: In this audit, we aimed to report critical incident and near misses during conduct of obstetric anesthesia over a period of two years. As health care is moving towards specialty and sub-specialty based practices all over the world It needs to be incorporated in our set up as well and as a first step, we start critical incident reporting in labor room suite where twenty four hours anesthesia services are available for one elective, one emergency theatre and labor room epidurals. Empty forms are available in both operating rooms of the Labor room operation room (LROR) These are filled on a voluntary basis by the medical and paramedical staff anonymously and are periodically reviewed and presented in academic meetings to educate, to increase awareness and to standardize and formulate guidelines. Literature of critical incident in anesthesiology in general is reported, no report from any obstetric unit was found in literature
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