Hofmeister Erik H, Reed Rachel A, Barletta Michele, Shepard Molly, Quandt Jane
Department of Surgery, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
Vet Anaesth Analg. 2018 May;45(3):345-350. doi: 10.1016/j.vaa.2018.01.001. Epub 2018 Jan 17.
To apply the critical incident technique (CIT) methodology to a series of perianesthetic cardiac arrest events at a university teaching hospital to describe the factors that contributed to cardiac arrest.
CIT qualitative analysis of a case series.
A group of 16 dogs and cats that suffered a perioperative cardiac arrest between November 2013 and November 2016.
If an arrest occurred, the event was discussed among the anesthesiologists. The discussion included a description of the case, a description of the sequence of events leading up to the arrest and a discussion of what could have been done to affect the outcome. A written description of the case and the event including animal signalment and a timeline of events was provided by the supervising anesthesiologist following discussion among the anesthesiologists. Only dogs or cats were included. After the data collection period, information from the medical record was collected. A qualitative document analysis was performed on the summaries provided about each case by the supervising anesthesiologist, the medical record and any supporting documents. Each case was then classified into one or more of the following: animal, human, equipment, drug and procedural factors for cardiac arrest.
The most common factor was animal (n=14), followed by human (n=12), procedural (n=4), drugs (n=1) and equipment (n=1). The majority (n=11) of animals had multiple factors identified.
Cardiac arrests during anesthesia at a referral teaching hospital were primarily a result of animal and human factors. Arrests because of procedural, drug and equipment factors were uncommon. Most animals experienced more than one factor and two animals arrested after a change in recumbency. Future work should focus on root cause analysis and interventions designed to minimize all factors, particularly human ones.
将关键事件技术（CIT）方法应用于某大学教学医院一系列围麻醉期心脏骤停事件，以描述导致心脏骤停的因素。
对一系列病例进行CIT定性分析。
一组16只犬猫，于2013年11月至2016年11月期间发生围手术期心脏骤停。
若发生心脏骤停事件，麻醉医生会对该事件进行讨论。讨论内容包括病例描述、心脏骤停前事件序列描述以及对如何改变结局的讨论。在麻醉医生讨论后，由指导麻醉医生提供包括动物特征和事件时间线的病例及事件书面描述。仅纳入犬或猫。数据收集期结束后，收集病历信息。对指导麻醉医生提供的每个病例总结、病历及任何支持文件进行定性文件分析。然后将每个病例归类为以下一种或多种心脏骤停相关因素：动物、人为、设备、药物和操作因素。
最常见的因素是动物（n = 14），其次是人为（n = 12）、操作（n = 4）、药物（n = 1）和设备（n = 1）。大多数动物（n = 11）被确定有多种因素。
转诊教学医院麻醉期间的心脏骤停主要是动物和人为因素所致。因操作、药物和设备因素导致的心脏骤停不常见。大多数动物经历了不止一个因素，且有两只动物在体位改变后发生心脏骤停。未来的工作应侧重于根本原因分析以及旨在尽量减少所有因素，尤其是人为因素的干预措施。
