ANZCA Choosing Wisely Recommendations 2017:

 

1.       No unnecessary pre-op tests (bloods, CXR, PFTs)

2.       No unnecessary pre-op stress tests

3.       No unnecessary transfusion

4.       No anaesthetising dying patients for high risk procedures unless there is a good reason

5.       No anaesthetising comorbid patients without proper assessment and planning

 

ANZCA Mortality Report 2012-2014

 

Demographics:

Overall

·      11 million episodes

·      200 anaesthesia-related deaths

·      i.e. mortality from anaesthesia very low, and if anything is getting lower

Patient

·      93% were ASA 3-5

·      87% were >60 years

Surgery

·      73% were emergency procedures

·      56% orthopaedic

·      10% abdominal

·      9% cardiothoracic

·      6% vascular

Other

·      Over-representation of non-anaesthetists providing sedation

 

Anaesthesia deaths:

Fault

·      23 Category 1 = definitely the anaesthetic

·      19 Category 2 = not entirely the anaesthetic

·      158 Category 3 = anaesthetic and medical/surgical factors

Anaesthesia deaths

·      7 anaphylaxis

·      6 aspiration

·      6 cardiac arrest

·      2 CICO

·      2 stroke from arterially placed CVC