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Chapter: Clinical Anesthesiology: Perioperative & Critical Care Medicine: Anesthetic Complications

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Out of the Operating Room Anesthesia and Monitored Anesthesia Care

Review of the ASA Closed Claims Project database indicates that anesthesia at remote (out of the oper-ating room) locations poses a risk to patients sec-ondary to hypoventilation and excessive sedation.

OUT OF THE OPERATING ROOM ANESTHESIA AND MONITORED ANESTHESIA CARE

 

Review of the ASA Closed Claims Project database indicates that anesthesia at remote (out of the oper-ating room) locations poses a risk to patients sec-ondary to hypoventilation and excessive sedation. Remote location anesthesia care was more likely than operating room anesthesia care to involve a claim for death (54% vs 29%, respectively). The endoscopy suite and cardiac catheterization laboratory were the most frequent locations from which claims were generated. Monitored Anesthesia Care (MAC) was the most common technique employed in these claims. Overwhelmingly, adverse respiratory events were most frequently responsible for the injury.

An analysis of the ASA Closed Claims Project database focusing on MAC likewise revealed that oversedation and respiratory collapse most fre-quently lead to claims. Claims for burn injuries suf-fered in operating room fires were also found in the database. Supplemental oxygen, draping, pooling of flammable antiseptic preparatory solutions, and sur-gical cautery combine to produce the potential for operating room fires.

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