Standards for Monitoring During Anesthesia at Harvard-Reply

In Reply.—  As the title indicates, these standards apply only to the hospitals affiliated with Harvard Medical School. In addition to expressing our concern for patient safety in anesthesia, the article was written to describe the use of mandatory, detailed day-to-day standards of practice as part of a risk-management program. We restate that we are not attempting to set national standards. We do urge replication of the committee process to create standards for anesthesia (which may vary by place and practice patterns) and other specialties as well.We acknowledge Dr Peterson's 30 years of clinical practice. Major anesthesia mishaps are rare events, and we, therefore, looked at large-group statistics rather than individual experiences. The fact that one has never had a major automobile accident is no reason to reject the proved safety resulting from seat belt use. Catastrophic anesthesia accidents continue to occur; many are due to undetected esophageal intubations