Significant Physiological Disturbances in Cases with and Without Non-Routine Events: An Analysis of Videotaped Anesthetics

It is important to understand the interactions among multiple factors affecting patient safety in the operating room. This paper describes data obtained using videotaped surgical cases that contained Non-Routine Events (NREs) versus Routine cases, as reported by anesthesia professionals. Random samples of videotapes were further analyzed for deviations of physiological parameters (vital signs) outside the accepted safe clinical range. The NRE cases contained significantly more vital sign deviations than routine cases. Additionally, vital signs were outside the standard clinical range a greater proportion of case time in NRE cases than in Routine cases. Nevertheless, there was a surprisingly high incidence of vital sign deviations during both types of cases. Such “routine” cases would otherwise not be reviewed or come under scrutiny in typical quality improvement efforts, even though they may contain valuable data about safety critical events.