Articles: mortality.
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A modified critical-incident analysis technique was used in a retrospective examination of the characteristics of human error and equipment failure in anesthetic practice. The objective was to uncover patterns of frequently occurring incidents that are in need of careful prospective investigation. Forty-seven interviews were conducted with staff and resident anesthesiologists at one urban teaching institution, and descriptions of 359 preventable incidents were obtained. ⋯ Overt equipment failures constituted only 14 per cent of the total number of preventable incidents, but equipment design was indictable in many categories of human error, as were inadequate experience and insufficient familiarity with equipment or with the specific surgical procedure. Other factors frequently associated with incidents were inadequate communication among personnel, haste or lack of precaution, and distraction. Results from multi-hospital studies based on the methodology developed could be used for more objective determination of priorities and planning of specific investments for decreasing the risk associated with anesthesia.
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The potential gains in total expectation of life and in the working life ages among the United States population are examined when the three leading causes of death are totally or partially eliminated. The impressive gains theoretically achieved by total elimination do not hold up under the more realistic assumption of partial elimination or reduction. ⋯ Even with a scientific break-through in combating these causes of death, it appears that future gains in life expectancies for the working ages will not be spectacular. The implication of the results in relation to the current debate on the national health care policy is noted.
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Am. J. Obstet. Gynecol. · Sep 1978
Maternal deaths from ectopic pregnancy in the South Atlantic region, 1960 through 1976.
The authors have calculated the maternal mortality rates from ectopic pregnancy in the Southeastern United States. Between 1960 and 1975 81 per cent of 207 ectopic deaths occurred in nonwhite women. ⋯ Maternal mortality rates for ectopic pregnancy should properly be based on the conception rate, consisting of live births plus abortions rather than live births alone. Missed diagnosis of ectopic pregnancy as a factor in maternal mortality rate requires more intensive educational efforts directed toward primary-care physicians.