Harvard Cites Anesthesia Deaths, Sets Up Guidelines
To improve patient care and prevent operating-room deaths, doctors have developed Harvard Medical School’s first mandatory standards for monitoring patients under anesthesia, a report released Friday says.
Of the 20 million patients who receive anesthesia each year during operations in the United States, an estimated 2,000 or more die of causes “primarily attributable to anesthesia,” the new report states.
Most of those deaths “are thought to be preventable,” says the report in Friday’s issue of the Journal of the American Medical Assn.
Anesthesiologists at Harvard’s nine affiliated teaching hospitals in the Boston area have developed rules for monitoring patients in the hope of preventing deaths or other mistakes.
Reducing Malpractice
Other hospitals could develop similar standards for taking care of their patients, a move that could reduce malpractice, the Harvard doctors contend in the report.
“Physicians traditionally have resisted standards of practice that prescribe specific details of their day-to-day conduct of medical care,” says the report by Dr. John H. Eichhorn, a Harvard anesthesiologist, and five colleagues. “Only vague or general standards of practice exist in American medicine.”
Although the Harvard anesthesiologists admit that their standards may not be applicable in other hospitals, they maintain that doctors in other medical specialties and hospitals could develop their own mandatory rules.
Monitoring Oxygen
One of the seven standards, for example, requires medical personnel to constantly monitor the flow of oxygen to a patient during all general anesthesia procedures.
The doctors found that one death at a Harvard-affiliated hospital “occurred when an old anesthesia machine without an oxygen monitor was used in an X-ray suite during a procedure.”
Other standards include requiring an anesthesiologist or nurse anesthetist to be present at all times when a patient receives anesthesia; monitoring the patient’s blood pressure and heart rate at regular intervals; and using a device that sounds an alarm if a problem develops in the anesthesia machine.
