Anaesthesia and intensive care
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Anaesth Intensive Care · May 2013
Primary anaesthetic deaths in Western Australia from 1985-2008: causation and preventability.
This paper reports on the causes and preventability of primary anaesthetic deaths in Western Australia between 1985 and 2008. In Western Australia, it is a legal requirement to report all deaths that occur within 48 hours of an anaesthetic and later deaths if an anaesthetic complication is implicated. A committee assesses whether an anaesthetic factor caused the death (a primary anaesthetic death) or contributed to the death (an anaesthesia-related death). ⋯ In the second 12-year period, there were fewer deaths overall (15 vs 38), proportionately fewer deaths related to failure to oxygenate (one vs six) and proportionately more deaths related to aspiration of gastric contents (four vs two). However, the percentage of deaths considered preventable was similar. These findings can be used to advise patients on anaesthetic risks, to educate anaesthetists about preventable deaths and to encourage the development of even safer anaesthetic drugs and techniques.
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Major burns have previously been considered a contraindication to solid organ donation. We present two cases of successful organ donation and transplantation, after Maastricht category III cardiac death in adult patients with non-survivable burns injury. The implications of the outcome of these cases are that major burns should not be considered a contraindication to organ donation, and that cardiac death provides opportunity for patients with non-survivable burns to contribute to the pool of potential organ donors.