Articles: anesthesia.
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Multicenter Study
The Thai Anesthesia Incidents Study (THAI Study) of pulmonary aspiration: a qualitative analysis.
To examine the risk factors, outcomes, and contributing factors associated with perioperative pulmonary aspiration. ⋯ Aspiration occurred commonly in patients with incomplete fasted or had prolonged gastric emptying time and underwent elective surgery. Additional training, continuing medical education and quality assurance tended to minimize the incidents.
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Multicenter Study
The Thai Anesthesia Incidents Study (THAI Study) of anesthetic outcomes: II. Anesthetic profiles and adverse events.
The purposes of the Thai Anesthesia Incidents Study (THAI Study) of anesthetic outcomes were to survey patients, surgical, anesthetic profiles and determine factors related to adverse events. ⋯ Respiratory adverse events were common anesthesia direct related events. High incidence of cardiac arrest and death within 24 hr highlighted concerns for prevention strategies. Incidents of adverse events can be used for institutional quality improvement, educational quality assurance and further research for patient safety in anesthesia.
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Multicenter Study
Mapping changes in surgical mortality over 9 years by peer review audit.
There is increasing public scrutiny of deaths among surgical patients. This analysis sought evidence of changes in practice over time in the management of patients who died under surgical care. ⋯ Through continuous peer review audit, the SASM has mapped and may have contributed to changes in surgical and anaesthetic practice over a 9-year period, indicating that the rate of adverse events can be decreased by changing clinician practice (DVT prophylaxis) and provision of facilities (HDU/ITU). Similar approaches should be considered by other medical specialties.
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Multicenter Study
The Thai Anesthesia Incidents Study (THAI Study) of perioperative death: analysis of risk factors.
National statistical data of mortality and morbidity related to anesthesia have not been reported. The need to comprehensively examine the cause of death as well as other adverse events prompted the first national study in Thailand. ⋯ This study shows incidence of 24-hr perioperative death of 1:354 which is comparable with other studies. Quality assurance activity, prevention of human failure and equipment failure, system improvement of perioperative care, availability of recovery room, intensive care unit, efficient blood bank and adequate number of MD. anesthesiologists are suggestive corrective strategies.
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Multicenter Study
Postoperative reintubation after planned extubation in Thai Anesthesia Incidents Study (THAI Study).
To analyze precipitating causes, outcomes and corrective strategies especially anesthetic related factors associated with reintubation after planned extubation in anesthetic technique of general anesthesia with endotracheal intubation. ⋯ More than 90% of RAP occurred in operating theater and recovery room were completely or partially related to anesthetic process. Incidence of RAP could be decreased by quality assurance process of recording, reporting and modeling care process together with increase individual experience.