Abstract
BackgroundEmergency "Anesthesia Stat!" (AS!) calls remain a common practice in medical centers even when advanced communication infrastructures are available. We hypothesize that the analysis of post-procedure "AS!" calls will lead to actionable insights which may enhance patient safety.MethodsAfter institutional review board approval, we prospectively collected data from April 2015 through May 2018 on "AS!" calls throughout the pediatric operating rooms (OR), off-site locations, and post-anesthesia care unit (PACU) at a tertiary university medical center. Data recorded included demographic information, location, time of the event, event duration, vital signs, medications, anesthesia staff, attending anesthesiologist, and staff responding to the call. A narrative account of the event was also documented.ResultsA total of 82 "AS!" calls occurred, with ages ranging from 11 days old to 17 years old. Forty-nine of the 82 calls (60%) occurred at emergence. Seventy-one of the 82 calls (87%) were solely respiratory-related. Thirty-five of 49 emergence calls (71%) occurred in the PACU. Further, 34 of 35 PACU calls (97%) were respiratory-related, with 30 of 35 PACU calls (86%) associated with desaturation requiring intervention by anesthesia staff. Finally, 31 of 35 PACU calls (89%) occurred within 30 minutes of patient arrival to PACU.ConclusionAnalysis of "AS!" events from our PACU continues to support the need for the prompt and continuous availability of at least one staff member with advanced airway management skills. Further, pediatric patients undergoing general anesthesia and surgery should likely be monitored for a minimum of 30 minutes following arrival in the PACU.
Highlights
Overhead emergency calls remain a common practice at many institutions [1,2,3]
Data recorded for each event included age, weight, American Society of Anesthesiologist (ASA) classification, history of recent upper respiratory infection (URI), any change in vital signs, lowest oxygen saturation (SpO2), anesthesia staff, and airway at time of AS! call
The primary finding of this study was that nearly half of AS! calls originated in the post-anesthesia care unit (PACU) during the period of observation
Summary
Overhead emergency calls remain a common practice at many institutions [1,2,3]. "Anesthesia Stat!" (AS!), the primary overhead emergency call in the operating room (OR), post-anesthesia care unit (PACU), and offsite locations, has been in use for over three decades. Events requiring an overhead emergency call are rare. Studying rare critical events may allow for improvements in patient care [4,5]. When compared to adult patients, pediatric patients may deteriorate faster in response to anesthesia-related adverse events, and studying critical incidents is necessary to improve patient outcomes and safety [6,7]. Emergency "Anesthesia Stat!" (AS!) calls remain a common practice in medical centers even when advanced communication infrastructures are available. We hypothesize that the analysis of post-procedure "AS!" calls will lead to actionable insights which may enhance patient safety
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