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Anaesthetists' attitudes to intraoperative death

Published online by Cambridge University Press:  25 November 2005

S. M. White  and
O. Akerele
S. M. White
Affiliation:
St. Thomas' Hospital, Department of Anaesthesia, London, UK
O. Akerele
Affiliation:
St. Thomas' Hospital, Department of Anaesthesia, London, UK
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Extract

Summary

Background and objectives: A recent survey in the British Medical Journal reported the attitudes of orthopaedic surgeons towards the intraoperative death of a patient. Several replies to this article were from anaesthetists, who pointed out that other staff might be affected by ‘death on the table’. We designed a questionnaire survey to assess the attitudes of anaesthetists, concerning intraoperative death. Methods: Three hundred anonymized questionnaires were distributed to 12 anaesthetic departments throughout England. Results: Two hundred and fifty-one replies were received (84% response rate); 92% of respondents had experienced an intraoperative death, the majority of deaths being expected (60%) and non-preventable (77%), occurring mainly during emergency surgery (80%), particularly involving vascular surgery (41% of cases); 87% had administered another general anaesthetic in the following 24 h, most without their professional ability being compromised (77%). Conclusions: This survey shows that anaesthetists are highly likely to experience intraoperative death, the consequences of which can be extremely stressful. Although the majority of anaesthetists (71%) agreed that it was reasonable for medical staff not to take part in operations for 24 h after an intraoperative death, fewer (25%) thought the proposal practicable. Nevertheless, all departments should provide for the discontinuation of further operations, if the circumstances require it. Consideration should be given by all departments of anaesthesia towards the prevention of intraoperative death, and the management of its aftermath, including the provision of support for psychologically traumatized staff.

Keywords

ANAESTHESIAMORTALITYINTRAOPERATIVE COMPLICATIONCOUNSELLING, medical staff, nursing staffSURGERY, complications
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 12 , December 2005 , pp. 938 - 941
Copyright
© 2005 European Society of Anaesthesiology

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