RESUMEN
The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel.
Asunto(s)
Anestesiología/normas , Procedimientos Quirúrgicos Cardíacos/normas , Quirófanos/normas , Seguridad del Paciente/normas , Médicos/normas , Sociedades Médicas/normas , Anestesiología/tendencias , Procedimientos Quirúrgicos Cardíacos/tendencias , Humanos , Quirófanos/tendencias , Médicos/tendencias , Calidad de la Atención de Salud/normas , Calidad de la Atención de Salud/tendencias , Sociedades Médicas/tendenciasAsunto(s)
Estenosis de la Válvula Aórtica/cirugía , Trasplante de Corazón/instrumentación , Trasplante de Corazón/métodos , Enfermedades de las Válvulas Cardíacas/cirugía , Corazón Auxiliar , Disfunción Ventricular Izquierda/cirugía , Adulto , Válvula Aórtica/anomalías , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Enfermedad de la Válvula Aórtica Bicúspide , Femenino , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Humanos , Ultrasonografía , Disfunción Ventricular Izquierda/diagnóstico por imagenRESUMEN
A high-speed motorcycle crash is a risk factor for thoracic aortic injury due to the rapid deceleration mechanism. We present a previously healthy 44-year-old man who was involved in a motorcycle accident. Initial spiral computed tomography indicated an intimal flap, which was visualized with evidence of mediastinal hemorrhage. The man was taken emergently to the operating room where a patent ductus arteriosus was seen at the location of the suspected aortic injury. No true aortic injury was appreciated.