In light of the recent death of comedienne Joan Rivers, study offers a timely review of adverse events associated with procedural sedation outside the OR.J Patient Saf. 2014 Sep 8; [Epub ahead of print].
Analysis of adverse events associated with adult moderate procedural sedation outside the operating room.
Karamnov S, Sarkisian N, Grammer R, Gross WL, Urman RD. J Patient Saf. 2014 Sep 8; [Epub ahead of print].The recent death of comedienne Joan Rivers, which followed a cardiac arrest during a routine throat procedure, has brought national attention to the potential safety hazards of office-based procedural anesthesia. This retrospective study examined adverse events associated with moderate procedural sedation performed outside of the operating room at a tertiary medical center. Adverse events were relatively rare, with only 52 safety incidents identified out of more than 140,000 cases over an 8-year period. The most common harm was oversedation leading to apnea and requiring the use of reversal agents or prolonged bag-mask ventilation. Women were found to be at particularly increased risk for adverse events including oversedation and hypotension. These findings suggest that a combination of patient and procedural characteristics may help risk stratify patients, allowing for appropriate responses such as increased monitoring and staffing for patients likely to experience sedation-related complications. A previous AHRQ WebM&M perspective described office-based anesthesia as the "Wild West" of patient safety.
Ambulatory care adverse events and preventable adverse events leading to a hospital admission.
Woods DM, Thomas EJ, Holl JL, Weiss KB, Brennan TA. Qual Saf Health Care. 2007;16:127-131.
What happens when things go wrong?
Brandom BW, Callahan P, Micalizzi DA. Paediatr Anaesth. 2011;21:730-736.
Paid malpractice claims for adverse events in inpatient and outpatient settings.
Bishop TF, Ryan AK, Casalino LP. JAMA. 2011;305:2427-2431.
STUDYView all related resources...
Medication injection safety knowledge and practices among anesthesiologists: New York State, 2011.
Gounder P, Beers R, Bornschlegel K, Hinterland K, Balter S. J Clin Anesth. 2013;25:521-528.