Warner Mary Ellen, Chong Elisa Y, Lowe Michael E, Sprung Juraj, Weingarten Toby N
From the Department of Anesthesiology, and Mayo Medical School, Mayo Clinic, Rochester, Minnesota.
Anesth Analg. 2014 Jul;119(1):145-150. doi: 10.1213/ANE.0000000000000264.
The nature of pages associated with periprocedural emergency events in ambulatory centers has never being examined. Our institution has a proprietary anesthesiology paging system with hierarchical paging capabilities (emergency versus routine) and maintains a log of all events. Here, we describe emergency pages in our ambulatory surgery centers.
We identified all emergency page activations between June 1, 2008, and December 31, 2012, in our ambulatory surgical centers. Electronic medical records were reviewed for rates and characteristics of pages such as primary cause, interventions performed, and outcomes.
During the study time frame, 120,618 procedures were performed and 93 emergency pages were recorded (7.7 per 10,000 cases, 95% confidence interval, 6.2-9.4), of which 51 originated in the procedure room and 42 outside the procedure room (16 before and 26 after the procedure). Among those, 14/93 were associated with serious events (1.2 per 10,000 cases). Among emergency pages for bradyarrhythmias (N = 35, 2.9 per 10,000 cases), 15 occurred during IV line placement in the preprocedural area, 11 during postprocedural recovery, and 9 during the procedure. Bradyarrhythmias accounted for 60.4% of pages outside the procedural room. In contrast, respiratory and airway events (N = 31, 2.6 per 10,000 cases) typically occurred in the procedural room (28 vs 9, P = 0.0006). Only 1 patient sustained permanent injury, myocardial infarction, and death 4 months later. Another patient died after 8 days from unrelated causes.
The rates of emergency page activations, especially those that are critical events, in our surgical ambulatory center are rare. Many emergency pages originated outside the procedural room; therefore, providers within these areas should be trained to promptly recognize and treat these events.
门诊中心围手术期紧急事件相关页面的性质从未被研究过。我们机构有一个具有分级寻呼功能（紧急与常规）的专属麻醉学寻呼系统，并保存所有事件的日志。在此，我们描述我们门诊手术中心的紧急寻呼情况。
我们确定了2008年6月1日至2012年12月31日期间我们门诊手术中心所有的紧急寻呼激活情况。查阅电子病历以了解寻呼的发生率和特征，如主要原因、所采取的干预措施及结果。
在研究时间段内，共进行了120,618例手术，记录到93次紧急寻呼（每10,000例中有7.7次，95%置信区间为6.2 - 9.4），其中51次起源于手术室，42次起源于手术室外（手术前16次，手术后26次）。其中，14/93与严重事件相关（每10,000例中有1.2次）。在缓慢性心律失常的紧急寻呼中（N = 35，每10,000例中有2.9次），15次发生在术前区域静脉置管期间，11次发生在术后恢复期间，9次发生在手术过程中。缓慢性心律失常占手术室外寻呼的60.4%。相比之下，呼吸和气道事件（N = 31，每10,000例中有2.6次）通常发生在手术室内（28次对9次，P = 0.0006）。只有1例患者遭受永久性损伤，发生心肌梗死，并在4个月后死亡。另一例患者在8天后因无关原因死亡。
我们门诊手术中心紧急寻呼激活的发生率，尤其是那些关键事件的发生率很低。许多紧急寻呼起源于手术室外；因此，这些区域的医护人员应接受培训，以便及时识别和处理这些事件。
