Anesthesia Standards Guideline: An International Update

An update of the International Standards for A Safe Practice of Anesthesia, was co-published with World Health Organization for the first time as an official WHO guideline by the World Federation of Societies of Anesthesiologists. The standards are recommended for anesthesia professionals throughout the world and are intended to provide guidance and assistance to anesthesia professionals, their professional societies, hospital and facility administrators, and governments for improving and maintaining the quality and safety of anesthesia care. They were first adopted by the WFSA on 13th June 1992, with revisions in 2008 and 2010. The latest version was published in May 2018 and was developed on behalf of both the WFSA and WHO.

The launch of the International Standards marks the increasing importance of surgery and anesthesia within global health policy. Recent seminal papers have highlighted major discrepancies in the provision of safe anesthesia and surgery worldwide [1, 2]. The Lancet Commission on Global Surgery estimated that five billion of the world's seven billion people do not have access to safe, affordable anesthesia and surgical care when needed [1]. As the essential role of anesthesia in the provision of surgical and obstetric care is not always understood by decision makers, the development of anesthesia has often been given a lower priority than the development of surgery per se in the global health agenda. Yet, access to safe anesthesia for essential surgery is a basic human right and should be available to all patients irrespective of their ability to pay.

On 22nd May 2015 the World Health Assembly passed the ground-breaking Resolution 68.15 entitled "Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage"[3]; a potential game-changer for the 5 billion people. The launch of the updated International Standards for a Safe Practice of Anesthesia supports this initiative by outlining concrete standards that every facility providing anesthesia can follow in specific areas including; facilities and equipment, medications and intravenous fluids, monitoring, conduct of anesthesia, and professional aspects.

Julian Gore-Booth, Chief Executive Officer of the WFSA, explained "Safe anesthesia saves lives. These standards contribute to WFSA's goal of safe anesthesia care for everybody and we are proud and delighted to have worked with WHO on our shared mission to include surgery and anesthesia as a component of universal health coverage."

Professor Adrian Gelb, Secretary of the WFSA highlighted that "Every patient in every country deserves safe anesthesia every time. This important WHO and WFSA endorsed set of standards takes an important step forward in clearly defining standards for every level of facility that provides general anesthesia, deep or moderate sedation."

"It is the hope of both organizations that ministries of health and hospital administrators will strive to implement them, if they are not already achieving the described level," he added. Dr Walter Johnson, Lead, WHO Emergency & Essential Surgical Care Programme, similarly highlighted the importance of the Standards and the collaboration adding, "The WHO-WFSA International Standards for a Safe Practice of Anesthesia is an important milestone in the development of global quality initiatives for improved surgical, obstetric and anesthesia service delivery platforms and health system strengthening."

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"Worldwide, enormous disparities exist between high-income and low-income countries regarding risk of patient death from anesthesia care. This international standard sets a reasonable, high standard to prevent unnecessary deaths due to unsafe practices, such as lack of monitoring, lack of essential medicines and lack of trained personnel," Dr Johnson explained. "This document will be extremely helpful to anesthesia practitioners, all levels of health facilities, government policy makers, health and finance ministers, and other stakeholders seeking to optimize the delivery of safe anesthesia care," he said finally.

The International Standards for a Safe Practice of Anesthesia will be discussed at an unofficial side event during the World Health Assembly open to the public, taking place at the Geneva Press Club on Tuesday 22nd May 2018, 9-11am. The event entitled "Briefing: How Can We Scale-up Surgery and Anesthesia to Achieve UHCs", co-hosted by the WFSA, Nesta, and Lifebox, will highlight the important work being undertaken to support WHA Resolution 68.15, including the launch of the International Standards, the ten year anniversary of the WHO Safe Surgical Checklist, as well as the Surgical Equity Prize launched by Nesta.

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Source-Eurekalert