[Perioperative risk and mortality after major surgery]

[Common veterinary practice in small animal anesthesia - an online survey among small animal practitioners in Europe]

OBJECTIVES

Survey concerning the situation of small animal anesthesia in Europe and assessment of the compliance with the guidelines of the AVA (American Society of Anesthesiologists) and the DVG specialty group VAINS (Veterinary Anesthesia, Intensive Care, Emergency Medicine, and Pain Management).

MATERIAL AND METHODS

A link to an online survey with questions concerning anesthesia management (topics include demographics, equipment, monitoring, thermal management, pre-anesthetic examination, anesthetic protocol, and others) was sent to small animal practitioners in several countries.

RESULTS

A total of 767 evaluable questionnaires came from Germany (n = 343), Austria (n = 216), Switzerland (n = 83), the United Kingdom (n = 38), France (n = 25), Hungary (n = 25), Scandinavia (n = 23), and "other countries" (n = 11). On average, 91 % of respondents complied with the AVA guideline and 58 % complied with the VAINS specialty group guideline even before its publication. Practices/clinics with higher staff possessed superior equipment, and practices/clinics performing higher numbers of anesthesias per week were more likely to implement "good preliminary examination."

CONCLUSION AND CLINICAL RELEVANCE

Although the guidelines were found to be implemented to a certain degree, the presented study reveals a potential for optimization of the anesthesia regime in many practices/clinics, e. g. by improving the equipment or allowing for better use of present apparatus.

[Implementation of Medical Emergency Teams to Improve Perioperative Patient Safety. Who? When? How?]

In contrast to prehospital emergency medicine, there are no comparable established structures or statutory requirements for structural and procedural organisation, or qualification of personnel and equipment for in-hospital emergency care in Germany. However, in perioperative patients, unexpected complications are fairly common on regular wards. Often, even hours before a possible critical event, warning signs of deterioration are present, which too often go unnoticed. Subsequently, potentially avoidable serious complications or cardiac arrest may occur. The establishment of so-called medical emergency teams (MET) serves to improve the emergency care organisation of the hospital and helps to avoid in-hospital cardiac arrest. The MET is alerted at an early stage of deterioration and uses a preventive therapy approach for pathophysiological deviations of the vital signs. This preventative approach can help to avoid in-hospital cardiac arrest and unplanned admission to an intensive care unit and thus contribute to increase perioperative patient safety.