PMID- 26479166
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20191210
IS  - 1467-2995 (Electronic)
IS  - 1467-2987 (Linking)
VI  - 43
IP  - 2
DP  - 2016 Mar
TI  - Adverse event surveillance in small animal anaesthesia: an intervention-based, 
      voluntary reporting audit.
PG  - 128-35
LID - 10.1111/vaa.12309 [doi]
AB  - OBJECTIVE: To develop, test and refine an 'intervention-based' system for the 
      surveillance of adverse events (AEs) during small animal anaesthesia. STUDY 
      DESIGN: Prospective, voluntary reporting audit. ANIMALS: A total of 1386 
      consecutive small animal anaesthetics (including 972 dogs and 387 cats). METHODS: 
      Adverse events were defined as undesirable perianaesthetic events requiring 
      remedial intervention to prevent or limit patient morbidity. Using previous 
      reports, 11 common AEs were selected and 'intervention-based' definitions were 
      devised. A voluntary reporting audit was performed over 1 year at a university 
      teaching hospital. Data on AEs were collected via paper checkbox forms completed 
      after each anaesthetic and were assimilated using an electronic database. 
      Interventions were performed entirely at the discretion of the attending 
      anaesthetist. Comparisons between dogs and cats were made using Fisher's exact 
      tests. RESULTS: Forms were completed for 1114 anaesthetics (a compliance of 
      80.4%), with 1001 AEs reported in 572 patients. The relative frequency of AEs 
      reported were as follows: arousal or breakthrough pain (14.9%), hypoventilation 
      (13.5%), hypotension (10.3%), arrhythmias (5.8%), hyperthermia/hypothermia 
      (5.0%), airway complications (4.8%), recovery excitation (4.6%), aspiration risk 
      (4.5%), desaturation (2.8%), hypertension (1.7%) and 'other' (3.7%). Canine 
      anaesthetics (57.3%) were more likely to involve AEs than were feline 
      anaesthetics (35.5%, p < 0.01). Escalation in postanaesthetic care was required 
      in 20% of cases where an AE was reported (8% of anaesthetics overall). In 6% of 
      cases (2% overall), this involved management in an intensive care unit. There 
      were six intra-anaesthetic fatalities (0.43%) during this period. The tool was 
      widely accepted, being considered quick and easy to complete, but several 
      semantic, logistical and personnel factors were encountered. CONCLUSIONS AND 
      CLINICAL RELEVANCE: Simple intervention-based surveillance tools can be easily 
      integrated into small animal anaesthetic practice, providing a valuable evidence 
      base for anaesthetists. A number of considerations must be addressed to ensure 
      compliance and the quality of data collected.
CI  - (c) 2015 Association of Veterinary Anaesthetists and the American College of 
      Veterinary Anesthesia and Analgesia.
FAU - McMillan, Matthew
AU  - McMillan M
AD  - Department of Veterinary Medicine, Queen's Veterinary School Hospital, University 
      of Cambridge, Cambridge, UK.
FAU - Darcy, Hannah
AU  - Darcy H
AD  - Department of Veterinary Medicine, Queen's Veterinary School Hospital, University 
      of Cambridge, Cambridge, UK.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20151019
PL  - United States
TA  - Vet Anaesth Analg
JT  - Veterinary anaesthesia and analgesia
JID - 100956422
SB  - IM
MH  - Anesthesia/adverse effects/*veterinary
MH  - Animals
MH  - Cats
MH  - Dogs
MH  - Evaluation Studies as Topic
MH  - Evidence-Based Practice/*methods
MH  - Management Audit
MH  - Prospective Studies
OTO - NOTNLM
OT  - adverse events
OT  - anaesthesia
OT  - audit
OT  - intervention
OT  - safety
EDAT- 2015/10/20 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/10/20 06:00
PHST- 2014/03/21 00:00 [received]
PHST- 2015/05/15 00:00 [accepted]
PHST- 2015/10/20 06:00 [entrez]
PHST- 2015/10/20 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - S1467-2987(16)30049-6 [pii]
AID - 10.1111/vaa.12309 [doi]
PST - ppublish
SO  - Vet Anaesth Analg. 2016 Mar;43(2):128-35. doi: 10.1111/vaa.12309. Epub 2015 Oct 
      19.