Setting priorities for patient safety
Runciman, W, Edmonds, M, Pradhan, M
Background: Current "flags" for adverse events (AEs) are biased towards those with serious outcomes, potentially leading to failure to address mundane common problems.
Crises in clinical care: an approach to management
A "crisis" in health care is "the point in the course of a disease at which a decisive change occurs, leading either to recovery or to death". The daunting challenges faced by clinicians when...
Crisis management during anaesthesia: hypertension
Paix, A, Runciman, W, Horan, B, Chapman, M, Currie, M
Background: Hypertension occurs commonly during anaesthesia and is usually promptly and appropriately treated by anaesthetists. However, its recognition is dependent on correctly functioning and...
Crisis management during anaesthesia: pulmonary oedema
Chapman, M, Myburgh, J, Kluger, M, Runciman, W
Background: Pulmonary oedema may complicate the perioperative period and the aetiology may be different from non-operative patients. Diagnosis may be difficult during anaesthesia and consequently...
Crisis management during anaesthesia: cardiac arrest
Runciman, W, Morris, R, Watterson, L, Williamson, J, Paix, A
Background: Cardiac arrest attributable to anaesthesia occurs at the rate of between 0.5 and 1 case per 10 000 cases, tends to have a different profile to that of cardiac arrest occurring elsewhere,...
Paix, A, Bullock, M, Runciman, W, Williamson, J
Background: Modern anaesthetic practice relies upon the administration of a wide range of potent drugs given by a variety of routes, at times in haste or under conditions of stress. Problems...
Crisis management during anaesthesia: awareness and anaesthesia
Osborne, G, Bacon, A, Runciman, W, Helps, S
Background: Patient awareness during general anaesthesia has considerable potential for severe emotional distress in the patient as well as professional, personal, and financial consequences for the...
Crisis management during anaesthesia: the development of an anaesthetic crisis management manual
Runciman, W, Kluger, M, Morris, R, Paix, A, Watterson, L, Webb, R
Background: All anaesthetists have to handle life threatening crises with little or no warning. However, some cognitive strategies and work practices that are appropriate for speed and efficiency...
Trauma: development of a sub-algorithm
Griggs, W, Morris, R, Runciman, W, Osborne, G, Paix, A
Background: Anaesthetists are regularly involved in the management of patients who have suffered trauma. Acute physiological derangements can occur at any time after the original injury, with life...
Crisis management during regional anaesthesia
Fox, M, Morris, R, Runciman, W, Paix, A
Background: Regional anaesthesia is widely used and has been considered to pose few risks once the block is established. However, life threatening problems can occur both during the establishment and...
Crisis management during anaesthesia: difficult intubation
Paix, A, Williamson, J, Runciman, W
Background: Anaesthetists may experience difficulty with intubation unexpectedly which may be associated with difficulty in ventilating the patient. If not well managed, there may be serious...
Crisis management during anaesthesia: recovering from a crisis
Bacon, A, Morris, R, Runciman, W, Currie, M
Preventing harm to the patient is the priority during a crisis. After a major incident, and especially when a patient has been harmed, there are a number of matters to be addressed: the ongoing care...
Crisis management during anaesthesia: desaturation
Szekely, S, Runciman, W, Webb, R, Ludbrook, G
Background: Desaturation occurs for many reasons under anaesthesia, some rare and obscure, and many potentially life threatening. The rapidity with which the cause is determined and appropriate...