A Review of Current Literature of Interest to the Office-Based Anesthesiologist

Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aim of this report was to describe the nature of pediatric postanesthesia care unit CA (PACU CA), subsequent patient outcomes, and factors associated with harm after pediatric PACU CA. Cases of PACU CA were drawn from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia. Demographics, underlying conditions, cause of CA, and outcomes were extracted. Descriptive statistics were used to characterize data and to assess risk of harm in those suffering CA. A total of 26 CA events were included: 67% in children <5 years, and 30% in infants (<1 year); 18 (69%) were deemed likely or almost certainly preventable. All preventable CAs originated as respiratory events and most (67%) had purported root causes that included poor provider judgment or inexperience, inadequate supervision, and competing priorities. CAs...