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Suggested Improvements

 

Information on Anesthesia Awareness

What Is Anesthesia Awareness?

Draft report on the America Society of Anethesiologists (ASA)

I'm Scheduled for Surgery.  What questions should I ask?

Help!  My Loved One or Friend Has Experienced Anesthesia Awareness and They're Driving Me Nuts!  What Do I Need to Know to Help Both of Us?

The History of the Anesthesia Awareness Campaign

A Partial and Evolving Bibliography for Anesthesia Awareness

Anesthesia Awareness President's Suggested Reading List

A/A Campaign's Suggestions For Improvement to the Anesthesia System

Links to Further Information on Anesthesia Awareness

Anesthesia Awareness Registry
www.awaredb.org

American Society of Anesthesiologists
www.asahq.org

American Association of Nurse Anesthetists
www.aana.com

The Joint Commission
www.jcaho.org

Aspect Medical Systems
www.aspectms.com

Interactive Webcast Forum on Anesthesia Awareness from OR Live
www.or-live.com/anesthesiaawareness/

SUGGESTIONS FOR IMPROVEMENT IN THE ANESTHESIA SYSTEM

FROM THE ANESTHESIA AWARENESS CAMPAIGN, INC.

February 3, 2004 *

* These suggestions, written February 3, 2004, closely resemble the suggestions in the Joint Commission on the Accreditation of Healthcare Organizations’ (JCAHO) Sentinel Event Alert #32 on Anesthesia Awareness, issued October 6, 2004.

Make time to speak to patients about their questions about anesthesia before surgery. Consider awareness a risk factor that should be disclosed; one no scarier than death, which is always discussed.

Remember that under the current system (at least in the US), a patient is expected to put their life in the hands of someone they’ve never met in an anesthesia provider; unlike a surgeon.

When patient movement occurs, please impress upon your peers and students to consider that their patient just may be trying to communicate awareness to you before more paralytic drug is automatically administered without an equal amount of sedation.

During surgery, talk to your patient by name, assuring them that you are there for them.

Consider teaching surgeons that completely debilitating amounts of paralytic neuro-blocking drugs are probably not necessary, and may allow more cases of awareness to slip through.

 

Make that post-op visit to the PACU and the hospital room for inpatients. It is not always done! Refer any awareness victims you happen to have to this campaign or some other research organization so a means of prevention can be found’ and a better means of treating the life-changing trauma can be given.

If a claim of awareness is made, insist that everyone take that claim seriously and handle it with care. Push for the development and use of protocols for such incidents.

Make sure all patients and their families get immediate professional psychological help.

Please consider or reconsider using available brain activity monitoring technology. I know the ASA claims it is not yet 100% accurate nor peer vetted by their organization, but it is better than nothing. And the FDA has endorsed it. So far the ASA committee to peer vet and take a stand on monitoring as not even met since October 14, 2003! There is nothing on the agenda about monitoring for the October 2004 general meeting. Obviously, action has to be taken outside the aegis of the ASA or the issue will never be "peer vetted." Brain activity monitoring must become as routine as pulse oximetry within the next five years. consider or reconsider using available brain activity monitoring technology. I know the ASA claims it is not yet 100% accurate nor peer vetted by their organization, but it is better than nothing. And the FDA has endorsed it. So far the ASA committee to peer vet and take a stand on monitoring as not even met since October 14, 2003! There is nothing on the agenda about monitoring for the October 2004 general meeting. Obviously, action has to be taken outside the aegis of the ASA or the issue will never be "peer vetted." Brain activity monitoring must become as routine as pulse oximetry within the next five years.

consider or reconsider using available brain activity monitoring technology. I know the ASA claims it is not yet 100% accurate nor peer vetted by their organization, but it is better than nothing. And the FDA has endorsed it. So far the ASA committee to peer vet and take a stand on monitoring as not even met since October 14, 2003! There is nothing on the agenda about monitoring for the October 2004 general meeting. Obviously, action has to be taken outside the aegis of the ASA or the issue will never be "peer vetted." Brain activity monitoring must become as routine as pulse oximetry within the next five years.

Because, you see, most of your future patients don’t
realize how important you are to the
rest of their lives! 

Now, let me take the liberty of giving you a question to consider: In many specialties, such as psychiatry, doctors are themselves required to undergo the treatment they will be giving. I feel it would be invaluable training for every anesthesia provider to experience paralyzation with awareness. How do you feel about that? Are you willing to undergo it? Do you think you would ever forget it? Should it be a required part of anesthesia training?

February 23, 2004

reprinted: May 8, 2004

3rd printing: September 8, 2004

4th printing: February 9, 2005

5th printing: May 1, 2005