Features  |   August 2015
Establishing and Reinforcing a Culture of Safety in Anesthesia Outside of the O.R.
Author Affiliations
  • Keira P. Mason, M.D.
    Chair, Abstract Review Subcommittee on Ambulatory Anesthesia Ex-Officio, Educational Track Subcommittee on Ambulatory Anesthesia
Article Information
Patient Safety / Features
Features   |   August 2015
Establishing and Reinforcing a Culture of Safety in Anesthesia Outside of the O.R.
ASA Monitor 08 2015, Vol.79, 12-15.
ASA Monitor 08 2015, Vol.79, 12-15.
Over the past two decades, the volume of anesthesia, sedation and monitored anesthesia care (MAC) demands in areas outside the O.R. has increased. Frequently, the patients are medically complex and undergoing high-risk procedures. The deliveries of anesthesia and sedation in these non-operating room anesthesia (NORA) areas have been associated with a comparatively higher risk of mortality than those anesthetics in the O.R. A closed claims analysis of claims after 1990 demonstrated that there was a higher proportion of deaths in remote locations.1  Pediatric dental anesthesia and sedation has recently garnered attention because of a perception of higher incidences of untoward events in this area. A review of closed claims for a leading malpractice insurance carrier revealed that between 1993 and 2007, there were 13 sedation-related pediatric dental deaths. It is estimated that there are between 100,000-250,000 pediatric dental sedations and anesthetics annually,2  In fact, a higher percentage of death was associated with pediatric dental sedation and anesthesia of children in the office-based setting between the age of 2-5 years who received moderate sedation via oral or I.V. route.3 
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