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.