Landrigan et al reported the Global Assessment of Pediatric Patient Safety (GAPPS) Tool to identify patient safety incidents for pediatric patients. One group deals with surgery-related issues. The authors are from Boston Children's Hospital, Harvard Medical School, Brigham and Women's Hospital, Children's National Medical Center, George Washington University, Stanford University and the Institute for Healthcare Improvement.
Patient selection: pediatric
Surgical triggers (S):
(1) drop of hemoglobin or hematocrit by > 25% within 24 hours
(2) mechanical ventilation > 48 hours after surgery
(3) noncardiac operative time > 6 hours
(4) unanticipated insertion of arterial or central line during surgery
(5) intra-operative administration of pressor agent during surgery (epinephrine, etc)
(6) unanticipated X-ray taken during surgery or in the recovery room
(7) return to surgery
(8) change in procedure
Additional triggers might be:
(1) excessive transfusion of blood products
(2) change in surgeon
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