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BACKGROUND Surgery has become an integral part of global health care, with an estimated 234 million operations performed yearly. Surgical complications are common and often preventable. We hypothesized that a program to implement a 19-item surgical safety checklist designed to improve team communication and consistency of care would reduce complications and(More)
BACKGROUND Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre(More)
BACKGROUND AND PURPOSE Improvements in cardiac surgery mortality and morbidity have focused interest on the neurological injury such as stroke and cognitive decline that may accompany an otherwise successful operation. We aimed to investigate (1) the rate of stroke, new ischemic change on MRI, and cognitive impairment after cardiac valve surgery; and (2)(More)
OBJECTIVES To sustain an argument that harnessing the natural properties of sociotechnical systems is necessary to promote safer, better healthcare. METHODS Triangulated analyses of discrete literature sources, particularly drawing on those from mathematics, sociology, marketing science and psychology. RESULTS Progress involves the use of natural(More)
These standards A are recommended for anesthesia professionals throughout the world. They are intended to provide guidance and assistance to anesthesia professionals, their professional societies, hospital and facility administrators, and governments for improving and maintaining the quality and safety of anesthesia care. They were adopted by the World(More)
A "crisis" in health care is "the point in the course of a disease at which a decisive change occurs, leading either to recovery or to death". The daunting challenges faced by clinicians when confronted with a crisis are illustrated by a tragic case in which a teenage boy died after a minor surgical procedure. Crises are challenging for reasons which(More)
BACKGROUND The mini-Clinical Evaluation Exercise (mini-CEX) is a workplace-based assessment which may be useful in anaesthesia training. However, its value depends on how supervisors use it with their trainees. This study analyses experience with the mini-CEX after its introduction into anaesthesia departments in our institution. METHODS We conducted(More)
BACKGROUND Acetaminophen is often used with a non-steriodal anti-inflammatory drug for acute pain. Hitherto, these drugs have had to be given separately, typically at different time intervals. Maxigesic tablets combine acetaminophen and ibuprofen in clinically appropriate doses to simplify administration and dosage regimen. We compared this combination with(More)
Thirty-five patients kept in a sitting position for 5 min after a standard extradural injection in labour were compared with 54 patients maintained in the left lateral position throughout. The mean upper limit of analgesia was unchanged. A significant shift of the mean lower limit occurred in the sitting patients (P = 0.05, two-tailed), but contrary to(More)
PURPOSE To enhance patient safety through contemporaneous and comprehensive standards for a safe practice of anesthesia that augment, enhance, and support similar standards already published by various countries and that provide a resource for countries that have yet to formulate such standards. STANDARDS DEVELOPMENT The Safe Anesthesia Working Group of(More)