DEFINITION 

           An INCIDENT is any event which affected or could have affected the                                                                                  safety of the patient while  under  anaesthetic care 

            Report any incident, no matter how trivial. 

            The incident need not have been preventable. 

            The incident may occur any time from before induction to after discharge from the recovery room.

 INSTRUCTIONS 

            Write in your own words a description of what happened. 

            Please give as much details as possible as it will help in the analysis of the incident.

            The incident concerns an item of equipment please identify the equipment (eg brand, model). 

            Tick all relevant boxes in pages 3 & 4. Place the report in the container provided. 

ANONYMITY 

            Do not identify the reporter or the patient on this form. 

           The only person who knows this information is you. 

QUALITY 

          All reports will be reviewed within our department. 

         The overall aim is to prevent recurrence of incidents. 

         We plan to identify causes of incidents, 

          alert all anaesthetists to problems that are occurring and develop preventive strategies as indicate