Anesthesia Problems More Likely Early in Academic Year

Among anesthesia trainees, first months linked to more undesirable events, even in senior trainees
By Eric Metcalf
HealthDay Reporter

WEDNESDAY, Oct. 14 (HealthDay News) -- Undesirable events are more common among anesthesia trainees at the beginning of the academic year, even in those with more clinical experience, according to research published Oct. 13 in BMJ.

Guy Haller, M.D., of the University of Geneva, and colleagues analyzed data from 19,560 patients undergoing anesthesia performed by first to fifth year trainees in their first year of residency in an Australian hospital.

The researchers found that the rate of undesirable events -- including severe uncontrolled hypotension and hypertension and technical failures in arterial line insertion -- was higher at the beginning of the academic year compared to the rest of the year (overall adjusted rate ratio, 1.40). The higher risk was seen in all residents, regardless of their seniority, decreasing after the first month and disappearing after the fourth month.

"Haller and colleagues remind us that patients with complex needs (for example, emergency cases) should be fully supervised when trainees are new," write the authors of an accompanying editorial. "Staffing patterns of attending doctors need to be carefully planned at the start of the academic year to compensate for inexperienced trainees. Reducing variation in patient care at the start of the academic year requires developing resilient systems in which individuals, teams, and their organization can adapt and compensate for the disruptions of incoming inexperienced trainees."

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