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      Handling injectable medications in anaesthesia : Guidelines from the Association of Anaesthetists

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          Summary

          Peri‐operative medication safety is complex. Avoidance of medication errors is both system‐ and practitioner‐based, and many departments within the hospital contribute to safe and effective systems. For the individual anaesthetist, drawing up, labelling and then the correct administration of medications are key components in a patient's peri‐operative journey. These guidelines aim to provide pragmatic safety steps for the practitioner and other individuals within the operative environment, as well as short‐ to long‐term goals for development of a collaborative approach to reducing errors. The aim is that they will be used as a basis for instilling good practice.

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          Evaluation of Perioperative Medication Errors and Adverse Drug Events.

          Karen C Nanji, Amit Patel, Sofia Shaikh … (2016)
          The purpose of this study is to assess the rates of perioperative medication errors (MEs) and adverse drug events (ADEs) as percentages of medication administrations, to evaluate their root causes, and to formulate targeted solutions to prevent them.
          Article 0 comments Cited 63 times – based on 0 reviews     Review now
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            Guidelines for the safe practice of total intravenous anaesthesia (TIVA)

            A Nimmo, A Absalom, O Bagshaw … (2018)
            Guidelines are presented for safe practice in the use of intravenous drug infusions for general anaesthesia. When maintenance of general anaesthesia is by intravenous infusion, this is referred to as total intravenous anaesthesia. Although total intravenous anaesthesia has advantages for some patients, the commonest technique used for maintenance of anaesthesia in the UK and Ireland remains the administration of an inhaled volatile anaesthetic. However, the use of an inhalational technique is sometimes not possible, and in some situations, inhalational anaesthesia is contraindicated. Therefore, all anaesthetists should be able to deliver total intravenous anaesthesia competently and safely. For the purposes of simplicity, these guidelines will use the term total intravenous anaesthesia but also encompass techniques involving a combination of intravenous infusion and inhalational anaesthesia. This document is intended as a guideline for safe practice when total intravenous anaesthesia is being used, and not as a review of the pros and cons of total intravenous anaesthesia vs. inhalational anaesthesia in situations where both techniques are possible.
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              The frequency and nature of drug administration error during anaesthesia.

              L Larsson, Angela Webster, Susan J. Weller … (2001)
              We aimed to establish the frequency and nature of drug administration error in anaesthesia (a significant subset of error in medicine) at two hospitals. Anaesthetists were asked to return a study form anonymouslyfor every anaesthetic, indicating whether or not a drug administration error or pre-error (defined as any incident with potential to become an error) had occurred. Further details were sought if the response was affirmative. From 10,806 anaesthetics, 7794 study forms were returned, representing response rates of 80% from Hospital A and 57% from Hospital B (72% overall). The frequency (95% confidence intervals) of drug administration error; of any type, per anaesthetic was 0.0075 (0.006 to 0.009), of i.v. bolus errors was 0.005 (0.0035 to 0.006) and of pre-errors was 0.004 (0.003 to 0.005), with no significant difference between hospitals. Overall, one drug administration error was reported for every 133 anaesthetics. The two largest individual categories of error involved incorrect doses (20%) and substitutions (20%) with i.v. boluses of drug. Of the i.v. bolus substitutions, 69% occurred between different pharmacological classes. One patient was aware while under muscle relaxation, and two required prolonged ventilation. In addition, 47 transient physiological effects were reported, of which five required intervention. We conclude that drug administration error during anaesthesia is considerably more frequent than previously reported.
              Article 0 comments Cited 49 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Anaesthesia
                Abbreviated Title: Anaesthesia
                Publisher: Wiley
                ISSN (Print): 0003-2409
                ISSN (Electronic): 1365-2044
                Publication date (Electronic): July 26 2023
                Affiliations
                [1 ] Department of Anaesthesia University Hospitals Bristol and Weston Bristol UK
                [2 ] Lympstone Devon UK
                [3 ] Department of Anaesthesia and Intensive Care London North West University Hospital Trust London UK
                [4 ] Department of Anaesthesia Aberdeen Royal Infirmary Aberdeen UK
                [5 ] NHS England London UK
                [6 ] Department of Anaesthesia James Cook University Hospital Middlesbrough UK
                [7 ] Department of Anaesthesia South Tyneside and Sunderland NHS Foundation Trust Sunderland UK
                [8 ] University of Oxford Oxford UK
                [9 ] Nuffield Department of Anaesthesia Oxford University Hospital NHS Foundation Trust Oxford UK
                [10 ] Department of Anaesthesia Queen Elizabeth Hospital Kings Lynn UK
                Article
                DOI: 10.1111/anae.16095
                PubMed ID: 37492905
                SO-VID: 38b1a3ea-fcdb-40a7-a733-7805048b2da4
                Copyright © © 2023
                License:

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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