05-29-2005, 06:12 AM
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Japan - 'Surgeon error behind bleeding'
http://www.yomiuri.co.jp/main/main-e.htm
'Surgeon error behind bleeding'
The Yomiuri Shimbun
Anesthesiologists believe about half the cases involving critical blood loss during operations are caused by errors in surgeons' judgment and problems with their technical skills, according to a survey conducted by the Japanese Society of Anesthesiologists.
Respondents to the survey said delays in delivering blood and a shortage of anesthesiologists also contributed to life-threatening blood loss in some cases.
In reaction to the survey's results, the Japanese Society of Anesthesiologists intends to start working with the Japan Society of Blood Transfusion to jointly compile a guideline to avoid such incidents. It also likely will ask the Japan Surgical Society to cooperate on the project.
The survey was conducted from late 2003 to early 2004 on 782 medical institutions identified by the anesthesiologists' society as well-equipped with plenty of staff. Of the total, 739 of the institutions replied.
The society sent questionnaires to the institutions, asking them to relate case details and the causes of critical massive blood loss in operations.
According to the survey results, there were 541 cases involving critical blood loss in 2003. Among the cases, 166 patients, or 31 percent, died because of massive bleeding during or shortly after operations.
Respondents were able to list multiple answers when asked about the cause of the blood loss.
The results show that 45 percent of cases were attributed to surgeon error and problems with technical skills. In another 45 percent of the cases, the anesthesiologists said they believed critical blood loss was inevitable due to the state of some injuries.
Other reasons given in the survey include a shortage of anesthesiologists at 29 percent, delays in the delivery of blood at 26 percent and delays on requests for additional blood at 25 percent.
Kazuo Irita, an assistant professor at Kyushu University, who led the society's special research committee for the survey, said: "There aren't so many cases in which individual doctors face critical blood loss in operations. So, there's always a danger that they wouldn't be able to take appropriate measures according to the situation. It's necessary to analyze the reasons more deeply and discuss how to cope with them earlier."
On the other hand, Masatoshi Makuuchi, president of the Japan Surgical Society who also is a professor at Tokyo University, said: "We'd like to take the survey results seriously. But there can be other factors involved in critical blood loss, such as the difficulty of an operation and an inefficient system to supply blood. It's necessary to examine the reasons further. But, if we're asked to cooperate and work out guidelines to guard against such situations, we want to consider it positively."
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Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
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