Читать книгу Pet-Specific Care for the Veterinary Team - Группа авторов - Страница 111

Failures occur in every industry, including veterinary medicine. However, few industries have been able to reduce human‐based error to the degree that the aviation industry has reported. Between 1993 and 2013, the number of worldwide flight hours doubled from 25 to 54 million, yet fatalities decreased from 450 to 250 per year [1]. By comparison, 200,000 people in the United States alone are estimated to die preventable deaths annually at the hands of human healthcare [2]. This rate of deaths equates to three fatal airplane crashes per day and would be considered unacceptable to the aviation industry: “Airlines would stop flying, airports would close … [and] no one would be allowed to fly until the problem had been solved” [3].

Comparisons are more difficult to make between veterinary medicine and the aviation industry due to the paucity of studies in the veterinary literature [4, 5]. Most veterinary publications examine anesthetic or surgical complications, not all of which stem from human error. In companion animal medicine, these include hypotension [8–8], dysphoria [9–11], cardiac arrhythmias [8], aspiration pneumonia [12], cerebellar dysfunction [13], blindness or deafness in cats [14–16], and death [17].

A retrospective study examined medical records from 98,036 dogs and 79,178 cats that underwent anesthetic procedures between June 2002 and 2004 in the United Kingdom. Brodbelt et al. determined the overall risk of anesthetic death to be 0.17% and 0.24% in dogs and cats respectively [18]. When categorized by health status, healthy dogs and cats experienced anesthetic death at the diminished rate of 0.05% and 0.11% compared to 1.33% and 1.40% in ill dogs and cats [18]. These percentages are much higher than 0.02–0.05%, which is the range reported for anesthetized people [19–21]. However, how much death is the result of medical error is unknown. Most of what is known is largely anecdotal, which begs the questions “How much error occurs that we don't know about and what can we do to prevent it?”