Dr. Rowan Molnar: Factors That Affect Quaternary Prevention in Anaesthesiology

As quaternary prevention continues to gain significance in the field of anaesthesiology, many specialists like Dr. Rowan Molnar believe that appropriate investigations must be made in the pre-operative stage in order to formulate effective therapeutic strategies. Only rational prescription of absolutely indicated drugs must be allowed during surgery and the post operative period as well. Anaesthesiologists can monitor the situation as they make post-operative rounds at the health centre.  They must discourage the unnecessary use of painkillers and alternative medicine for prophylactic purposes. This will help fulfil the objective of quaternary prevention, which is to protect patients from new medical invasions. In such cases, only ethically acceptable interventions that are supported by evidence should be practiced.

The challenges

In anaesthesia, there often exists a state where there is no definitive opinion either in favour of or against treatments available in specific clinical situations. Challenging situations can arise when administering anaesthesia in special populations of paediatrics, obstetrics and geriatrics where a specific technique requires to be selected over another. The presence of co-morbidities can influence the anaesthetics decision. In such a scenario, a team-based decision for a less invasive option where surgery, medicine and anaesthesiology much be taken. The decision must consider practical aspects such as the skills of professionals, availability of manpower and physical resources available.

The need for a proactive approach

Dr. Rowan Molnar, who is a Staff Specialist Anaesthetist at Launceston General Hospital in Australia and Educator at numerous external organisations is of the opinion that the avoidance of promotion of any disease process in critical care units where the risk of cross-infection is high must be considered in quaternary prevention. In such cases, the health worker is responsible for cross-infections with pathogens. The anaesthesiologist who may suffer from blood bone infection could transmit causative organisms inadvertently to a patient. In anaesthesiology, quaternary prevention goes beyond therapeutics and includes supportive measures and diagnostic issues. The anaesthesiologist must recommend diagnostic tests and procedures with a practical approach. An example of over-mediatisation could be the order of an echocardiography for every pre-anaesthetic patient where the waiting period for the test could be months. In addition, denying a relevant pre-operative test for high risk cardiac patients could also be a case of medical negligence, which is unacceptable.

Written by a professional author who describes the detail of Dr. Rowan Molnar. 

Dr Rowan Molnar : The Importance of Quaternary Prevention in Anaesthesiology

Anaesthesiology is a rapidly growing science where numerous technically advanced equipment and new drugs with a higher safety margin have increased. This is reflected in the variety of instruments and medicines used in operation theatres and critical care units. In addition, anaesthesiologists now have the potential to create numerous combinations and permutations of drugs and procedures to enhance the safety and effectiveness of patient care. Such a scenario can be a bane as well as a boon since the increase in equipment mandates that anaesthesiologists and other staff in the operating room and critical care require to constantly updating their skills. At the same time it can increases the risk of errors.

A boon and a bane

The concept of quaternary prevention plays an integral role in such as scenario. For the most part, quaternary is defined as the measures taken to identify patients at risk of overmedication and to protect them from new medical invasion and to suggest ethically acceptable interventions. The concept has now been widely accepted in various branches of medicine. Specialists like Dr. Rowan Molnar believe that anaesthesiologists have the responsibility to ensure that quaternary prevention becomes routine in their practice.  They must be able to take proactive measures to identify patients at risk of overmedication and wrong medication as well. Some of these procedures can lead to medication errors and side effects that can prove detrimental to a patient’s health.

A patient-centric approach

Dr. Rowan Molnar, a Staff Specialist Anaesthetist at Launceston General Hospital in Australia, is of the opinion that quaternary prevention can be achieved when initiated from pre-anaesthetic clinic where patients may have a prescription of unnecessary vitamins and alternative or complementary medicines. An effort must be made to reduce the use of drugs and pills at this stage. Patients can be encouraged to refrain from these medicines for health reasons since it could affect them in the peri-operative stage. It is also essential to ensure that patients do not stop necessary medications. Like many others in the field, Dr. Rowan Molnar believes that relevant investigations must be implemented to quantify the effects and side-effects of present medications. This helps in planning and formulating effective therapeutic strategies.

Written by professional authors who describe the detail of Dr. Rowan Molnar. For more information about Dr. Rowan Molnar visit Linkedin.