A matter of conscience: A call to action for system improvements involving epidural and spinal catheters

Anesthesia and Analgesia

Volumn 114, Issue 3, 2012, Pages 494-496

  Birnbach, David J ^a   Vincent, Charles A ^b  

^a UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

^b IMPERIAL COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIHYPERTENSIVE AGENT; CHLORHEXIDINE; HYPERTENSIVE AGENT; NEUROMUSCULAR BLOCKING AGENT; TRANEXAMIC ACID;

ANESTHESIST; CONSCIENCE; EDITORIAL; EPIDURAL CATHETER; EPIDURAL SPACE; HUMAN; LUMBAR PUNCTURE; PARALYSIS; PRIORITY JOURNAL; SYRINGE; UNITED STATES;

ANESTHESIA, EPIDURAL; CATHETERIZATION; CONSCIENCE; HUMANS;

EID: 84857582674     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1213/ANE.0b013e318245c1b8     Document Type: Editorial

References (15)

1. Berkowitz RL. Of parachutes and patient care: a call to action. Am J Obstetrics and Gynecology 2011;205:7-9
2. Merry AF, Cooper JB, Soyannwo O, Wilson IH, Eichhorn JH. An iterative process of global quality improvement: the International Standards for a Safe Practice of Anesthesia. Can J Anaesth 2010;57:1021-6
3. International Taskforce on Anaesthesia Safety. International standards for the safe practice of anesthesia. Eur J Anaesthesiol 1993;10:12-5
4. Merry AF, Cooper JB, Soyannwo O, Wilson IH, Eichhorn JH. International standards for a safe practice of anesthesia. Can J Anaesth 2010;57:1027-34
5. McHaourab A, Ruiz F. Inadvertent caudal epidural injection of cefazolin. Anesthesiology 2001;94:184
6. Sanchez-Bailen MJ, Roca P, Beniloch R. Accidental administration of atracurium through an epidural catheter. Rev Esp Anestesiol Reanim 2006;53:4555-6
7. Kasaba T, Uehara K, Katsuki H, Ono Y, Takasaki M. Analysis of inadvertent epidural injection of drugs. Masui 2000;49: 1391-4
8. Huang SY, Wang CC, Chang WK, Chan KH, Chu CC. Intravenous propofol precipitates the hypotension induced by inadvertent epidural thiopental injection. Acta Anaesthesiol Taiwan 2006;44:239-42
9. Mohseni K, Jafari A, Nobahar MR, Arami A. Polymyoclonus seizure resulting from accidental injection of tranexamic acid in spinal anesthesia. Anesth Analg 2009;108:1984-6
10. National Patient Safety Agency patient Safety Alert. Safer Spinal, Epidural and Regional Anaesthesia Devices-Part A. London: National Patient Safety Agency, 2009
11. Cassidy CJ, Smith A, Arnot-Smith J. Critical incident reports concerning anaesthetic equipment: analysis of the UK National Reporting and Learning System (NRLS) data from 2006-2008. Anaesthesia 2011;66:879-88
12. National Patient Safety Agency. Patient Safety Alerts NPSA/2009/PSA004A and NPSA/2011/PSA001. London: National Patient Safety Agency
13. Cook TM, Payne S, Skryabina E, Hurford D, Clow E, Georgiou A. A simulation-based evaluation of two proposed alternatives to Luer devices for use in neuraxial anaesthesia. Anaesthesia 2010;65:1069-79
14. Leape LL. Who's to blame? The Joint Commission Journal on Quality and Patient Safety 2010;36:150-1
15. Lanigan CJ Safer epidural and spinal connectors, Anaesthesia 2002;57:567-71