| Popis: |
Introduction Optimization of anesthesiology benefits by conducting an internal medical audit based on the registration of crit- ical incidents. Material and Methods An internal medical audit was applied to different ver- sions of the anesthesiological aid carried out during sur- gical interventions in the conditions of one-day surgery. The age of patients ranged from 0 to 16 years. In most cases, operations were performed as planned. Results In our study, 498 critical incidents were recorded in pa- tients, so the frequency of critical incidents (CHI) was 0.63 ± 0.03 incidents per operation. When analyzing crit- ical incidents at the stages of various options for anesthe- sia, we found that their greatest number occurs at the stages of induction anesthesia and in the postoperative period (184 and 139, respectively). At the stage of maintaining anesthesia, the number of crit- ical incidents is two times less than at the previous stage and does not significantly differ from that at the stage of awakening the patient. The most common critical inci- dent at the stage of induction of anesthesia in children is laryngospasm caused by insufficient depth of anesthesia. Our study results showed that CI associated with the car- diovascular system were recorded at all stages of the an- esthesiological aid, including the postoperative period. However, they were more often observed during induc- tion of anesthesia (57) and maintenance of general anes- thesia (38). So, all patients of this group, bypassing the wake-up chamber, were immediately transferred to the surgical ward immediately after the operation. Since complete awakening occurred in patients of this group on the operating table and hemodynamic parameters re- mained stable. Conclusion Reasonable inclusion of patients in the fast track group significantly saved their costs operated in the conditions of one-day surgery. |
