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Safety in Anaesthesia Dr Jim Cooper Consultant anaesthetist University Hospitals Sussex 9/4/22 BSMS Conference First do no harm  Unconscious  Apnoeic Primum non  Hypotensive nocare  ParalysedMonitoring Pulse oximetry CO2 BP ECG Vapours Ventilators TIVA EntropyLots of machines that go pingComparisons with airline industry Adjuncts Laryngeal Mask Airway (LMA) Size: range available from <5kg to adult size Smaller sizes very easy to misplace or dislodge Potentially very useful in “can’t intubate, can’t ventilate” scenarioOur LeaderHuman Factors 70 % Errors Caused by Human Error The whole thing!!  What-how-why-who(m) Listen –barriers 1 way v 2 way Tone of voice-Non verbal Communication communication Watch re numbers and abreviations Handover if you have any is crucial time SBAR Assertiveness Support others  Solve problems  Sort Conflicts Teamwork  Coordinate activity  Practice helps as in all thingsPerformance = HUMAN FACTORS Direct factorWhy do we Managing factors ke errors? Potential factors Three Buckets 3 Model 2 J Reason 1 Personal Situational TaskThe Swiss Cheese Model Gather information Situational  Interpret information  Anticipate what next! awareness HWP lift issue leading to a patient cancelled and a patient getting stuck in the lift  DSU anaphylaxis to antibiotic  Bloods taken on obs patient not DATIX labelled (after 5 times attempt)  Wire removal issue post PA catheter in cardiacCall for helpQUESTIONS?