Prof. Michael IRWIN
The University of Hong Kong
Michael G. Irwin, MB ChB, MD, FRCA, FCAI, FANZCA, FHKAM, is the Daniel CK Yu Professor in the Department of Anaesthesiology, University of Hong Kong. He is Past President of the Society of Anaesthetists of Hong Kong and of the Hong Kong College of Anaesthesiology. Prof. Irwin has published around 300 articles in peer reviewed scientific journals (h index 45) and is a regular invited journal reviewer. He is an editor of Anaesthesia, Perioperative Medicine, Expert Opinion on Pharmacotherapy and senior editor of the HK Medical Journal. He is on the Faculty of Evidence Based Perioperative Medicine (EBPOM) and was Chairman of the organizing committee for the World Congress of Anaesthesia 2016. Research interests include intravenous anaesthesia, pharmacology, perioperative medicine/enhanced recovery and the effects of anaesthesia on cancer.
In 1949, the Council of the ‘Association of Anæsthetists of Great Britain and Ireland’ (AAGBI) announced the launch of an ‘investigation of deaths associated with administration of anæsthetics’. Two articles describing specific complications associated with death were published during the investigation and the complete report, ‘Deaths associated with anæsthesia’ was published in Anæsthesia in 1956. There are many features of the manuscript which seem remarkable to us in the present day. The investigators were resourceful and innovative when pioneering such audit. They recognised the importance of anonymity if deaths were to be reported willingly, and they also had to invent a system for assessing patients’ fitness, because ASA physical status scoring system was not adopted until 1962. The investigation was the first proper attempt to audit deaths related to anaesthesia and the first to analyse specifically the causes of these deaths and to attempt to classify them. The factors making a significant contribution to death were classified under 22 headings and the causes of each were described in detail. The authors considered that 598 of 1000 deaths investigated were due wholly or significantly to anaesthesia. This report occurred on the cusp of and perhaps hastened dramatic changes in our specialty. Such audit is now an integral and extremely important part of our practice, the impact of which will be presented.