RESUMEN
We aimed to establish the frequency and nature of drug administration error in anaesthesia (a significant subset of error in medicine) at two hospitals. Anaesthetists were asked to return a study form anonymouslyfor every anaesthetic, indicating whether or not a drug administration error or pre-error (defined as any incident with potential to become an error) had occurred. Further details were sought if the response was affirmative. From 10,806 anaesthetics, 7794 study forms were returned, representing response rates of 80% from Hospital A and 57% from Hospital B (72% overall). The frequency (95% confidence intervals) of drug administration error; of any type, per anaesthetic was 0.0075 (0.006 to 0.009), of i.v. bolus errors was 0.005 (0.0035 to 0.006) and of pre-errors was 0.004 (0.003 to 0.005), with no significant difference between hospitals. Overall, one drug administration error was reported for every 133 anaesthetics. The two largest individual categories of error involved incorrect doses (20%) and substitutions (20%) with i.v. boluses of drug. Of the i.v. bolus substitutions, 69% occurred between different pharmacological classes. One patient was aware while under muscle relaxation, and two required prolonged ventilation. In addition, 47 transient physiological effects were reported, of which five required intervention. We conclude that drug administration error during anaesthesia is considerably more frequent than previously reported.
Asunto(s)
Anestesia , Anestésicos , Errores de Medicación , Anestésicos/administración & dosificación , Recolección de Datos , Humanos , Incidencia , Errores de Medicación/estadística & datos numéricos , Estudios Prospectivos , Gestión de RiesgosRESUMEN
Employability is an important issue for adolescents and young adults with congenital heart disease. This article provides an overview of specific federal laws that protect these individuals and information about state vocational rehabilitation programs. Guidelines are provided to help health care providers counsel their patients more effectively.
Asunto(s)
Empleo , Cardiopatías Congénitas/rehabilitación , Orientación Vocacional , Adolescente , Adulto , Empleo/legislación & jurisprudencia , Humanos , Prejuicio , Rehabilitación Vocacional , Estados Unidos , Orientación Vocacional/legislación & jurisprudenciaRESUMEN
Transcutaneous electrical stimulation as a means of relieving acute pain was evaluated in 100 patients who underwent abdominal or thoracic operative procedures. Transcutaneous electrical stimulation proveded pain relief in 77 per cent of test patients as opposed to 17 per cent of control patients. Transcutaneous electrical stimulation is an effective method of treatment that has many advantages over analgesic drugs.