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Standards for Monitoring During Anesthesia

E. Bruce Johnson, MD
JAMA. 1987;257(11):1472-1473. doi:10.1001/jama.1987.03390110048015.
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To the Editor.—  I disagree strongly with the views expressed by Dr Peterson.1 The article on standards for monitoring during anesthesia2 does not do "a disservice to the practicing anesthesiologist and a service to the legal profession." Lamentably, it is long overdue.Dr Peterson argues against such standards and against one of the most useful monitors in the operating room (the end-tidal carbon dioxide monitor), using three arguments: his experience, the costs involved, and legal fears.He may not have encountered "a case in which the outcome could have been changed by the presence of such a monitor," but, with respect to his experience, if he hasn't used end-tidal carbon dioxide monitoring, on what can he base his opinion or assess outcome? Recent publications3,4 disclose numerous tragedies that could have been prevented by better quality of care, including, but not limited to, end-tidal carbon dioxide monitoring.

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