[Fatalities due to nitrous oxide. Complications from mistakes in nitrous oxide supply].

Der Anaesthesist
H HerffV Wenzel

Abstract

Despite inspiratory oxygen fraction measurement being regulated by law in the European norm EN 740, fatal errors in nitrous oxide delivery still occur more frequently than expected, especially after construction or repair of gas connection tubes. Therefore, if nitrous oxide is to be used further in a hospital, all technical measures and system procedures should be employed to avoid future catastrophes. Among these are measurement of the inspiratory oxygen fraction (F(I)O(2)) and an automatic limitation of nitrous oxide. Also all anaesthetists involved should be informed about repair or construction of central gas supply tubes. Additionally, more awareness of this problem in daily routine is necessary. Furthermore, a system of detecting and analysing errors in anaesthesia has to be improved in each hospital as well as in the anaesthesia community as a whole. Measures for a better "error culture" could include data exchange between different critical incident reporting systems, analysis of closed claims, and integration of medical experts in examination of recent catastrophes.

References

Jul 19, 2001·Der Anaesthesist·K E Hecker
Sep 15, 2001·BMJ : British Medical Journal·D I Saunders, T Meek
May 29, 2002·Anesthesia and Analgesia·Seiji IshikawaKoshi Makita
Dec 19, 2002·Quality & Safety in Health Care·Jeffrey B CooperBucknam McPeek
Aug 24, 2005·Anesthesia and Analgesia·Stefan A Ianchulev, Mark E Comunale
Nov 24, 2006·Anesthesiology·Robert S Lagasse
Nov 24, 2006·Anesthesiology·Frederick W CheneyKaren B Domino
Nov 24, 2006·Anesthesiology·André LienhartEric Jougla
Dec 30, 2006·Journal of Perioperative Practice·Paul Wicker, Brian Smith
Aug 30, 2007·Der Anaesthesist·M HüblerT Koch
Nov 10, 2007·Anaesthesia·H HerffV Wenzel

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