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Reports of retained guidewires draw attention to 'never events' in anesthesia
Date:6/20/2013

San Francisco, CA. (June 20, 2013) Retention of guidewires used to place central venous catheters (CVCs) is a complication that is considered always preventablebut nevertheless still happens, according to a report in the July issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Dr Andrea Vannucci and colleagues report their hospital's experience of four patients with retained guidewires, and analyze risk factors for these rare, preventable medical errors. A pair of accompanying editorials support the need for more open discussion of so-called "never events," along with systems approaches to minimize the chances of their occurring.

'Never Events' Should Never HappenBut Still Do

Dr Vannucci and coauthors report on four cases of retained guidewires after CVC placement. Guidewires help in placing CVCs, which are widely used for patient monitoring, fluid or drug administration, and other essential purposes. All four patients underwent CVC placement during complex surgeries such as lung transplantation. The presence of the guidewire was missed on routine postoperative x-rays, and went unrecognized for up to two days after surgery.

Dr Vannucci and colleagues analyzed each case in detail to identify potential contributing factors. Retained guidewires are regarded as "sentinel" safety problem or "never event"they should never occur as long as routine precautions are followed.

All four patients became unstable during surgery, requiring "urgent and complex" procedures. In two cases, there was confusion related to the use of two different guidewires.

Another contributing factor was "inattention blindness" because of the patients' unstable condition, supervising doctors were distracted from ensuring that residents assisting in the operating room followed proper steps in guidewire and CVC placement. "We suggest that distraction of the clinicians an
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Contact: Connie Hughes
connie.hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

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