The incident reporting system does not detect adverse drug events: a problem for quality improvement.

Objectives: The objectives of this study were 1) to determine the frequency with which adverse drug events result in an incident report (IR) in hospitalized patients; and 2) to determine if there were differences between quality assurance administrators, nurse leaders in quality assurance, and staff nurses as to whether an incident report should or would be filed for each adverse drug event.

Study Design: All patients admitted to five patient care units (one medical intensive care unit, two surgical intensive care units, and two medical general care units) in one academic tertiary care hospital were studied between February and July 1993. The main outcome measures used were adverse drug events (ADEs) and IRs.

Intermediate TISS: a new Therapeutic Intervention Scoring System for non-ICU patients.

Objective: To modify the Therapeutic Intervention Scoring System (TISS) for intermediate and floor care nursing units.

Design: Prospective study.

Setting: University teaching hospital.

Effect of pulse oximetry, age, and ASA physical status on the frequency of patients admitted unexpectedly to a postoperative intensive care unit and the severity of their anesthesia-related complications.

Unanticipated intensive care unit admission (UIA) associated with anesthesia served as an outcome measure to assess the quality of anesthesia care in a large teaching hospital. We characterized the patient population and types of problems associated with UIAs, attempted to identify patterns of care that could have led to specific adverse outcomes, and determined if a specific intervention, pulse oximetry, reduced UIAs. During a consecutive 65-wk period (July 1985-September 1986), 17,093 surgical patients were expected to enter the recovery room and then return to floor care.

Effect of labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study.

Labetalol, a combined alpha 1- and nonselective beta-adrenergic blocking drug, was compared to lidocaine or saline to minimize the hypertensive and tachycardic response to intubation in a controlled randomized double-blind study in patients undergoing surgical procedures under general anesthesia. Forty adult patients were divided into four groups of 10 each: placebo (saline), lidocaine 100 mg, labetalol 5 mg, or labetalol 10 mg. The double-blind preparation was administered as an IV bolus just prior to induction and 2 min before the stimulus of laryngoscopy and intubation.

The autopsy incidence of acute pulmonary embolism in critically ill surgical patients.

Critically ill patients should be susceptible to pulmonary thromboembolism (PTE). To determine the incidence of acute PTE in this patient population, we reviewed hospital charts and autopsy findings of all Class IV critically ill patients admitted to our hospital's Recovery Room-Acute Care Unit, between 1972 and 1982. Massive PTE either contributed to or was the sole cause of death in only two of the 152 patients studied (1.