BJA Advance Access originally published online on October 14, 2004
British Journal of Anaesthesia 2005 95(1):88-94; doi:10.1093/bja/aeh281
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
REVIEW ARTICLE |
Preventing surgical deaths: critical care and intensive care outreach services in the postoperative period
The Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
E-mail: david.goldhill@rnoh.nhs.uk
Keywords: intensive care, audit; recovery
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Introduction |
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The last 200 years have seen enormous improvements in the management of patients undergoing surgery. This has been in part because of key discoveries such as anaesthesia, asepsis, antibiotics and X-rays, to name but a few. There have also been important organizational changes, including the development of postoperative recovery rooms and critical care, that have made important contributions to postoperative safety. Surgical mortality has fallen while the range and invasiveness of surgical procedures have expanded. Operations are undertaken on patients who would have formerly been deemed unsuitable because of serious comorbidity, age or physiological derangement. Surgery is not without its risks. Deaths directly attributable to anaesthesia are extremely rare. However, anaesthetic management and postoperative care are important in preventing surgical deaths. There will undoubtedly be further discoveries that will benefit patients having surgery. There is good evidence that a greater provision of critical care support can save lives now.
Henry
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Recognizing high-risk surgical patients |
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Preoperative identification
Intraoperative identification
Postoperative identification
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The critical care gap |
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Preventing surgical deaths |
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Intensive care outreach services (ICORS) |
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Background
Early warning scores
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Critical care and surgical patients |
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Conclusions |
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