Critical Incidents in Orthopaedic Anaesthesia in a Tertiary Hospital: A Prospective and Retrospective Study

Abstract

Background: Critical incident reporting is accepted as an effective tool to enhance anaesthesia safety. It also helps to overcome or prevent human errors and system failures. The present study was undertaken to record anaesthesia related critical incidents in patients undergoing elective orthopaedic surgical procedures and identify the incidence and potential risk factors leading to critical incidents during anaesthesia. This Method: prospective and retrospective observational study was conducted in patients of both sexes, above 18 years of age, who met with critical incidents while undergoing any kind of elective surgeries under anaesthesia in orthopaedic operation theatres of a tertiary care teaching hospital during a period of 2 years from June 2018 to May 2020. During the study period, anaesthesia was given Results: to a total of 4677 patients out of which 152 (3.25%) patients met with 310 critical incidents. Out of 310 critical incidents, 57.98% was attributable to anaesthesia, 1.94% was equipment related, 13.55% surgery related, 0.65% patient related and 25.88% was recovery related. However, cardiovascular (17.42%), airway (6.45%) and respiratory (3.87%) related critical incident were the most common. Most of the patients recovered fully (94.7%) and most of the events were preventable (96.05%). Critical incident reporting system can be established based on Conclusion: the data obtained and it should be there in all departments and continued training for such events can reduce severity and frequency of these occurrences. Anaesthesia related critical incidents should be continued to be reported and analysed to reduce risks and improve patient safety.