I hesitated before writing this topic. Why? Because this topic has been discussed many times in the teachings of many previous experts, so would it be offensive to repeat it? Will it be thought that I always have to repeat the same old story, in everyone’s ear chatter to make people disgusted? During the spring break at home, I cleared my mind and repeatedly read some reports of anesthesia accidents and complications reported in the garden and by others in recent years, and felt that as an old anesthesiologist who has worked for many years, I should still say. Many anesthesia incidents occurred in our country, the overall analysis of both large hospitals with good conditions, but also very poor conditions of the primary hospital, death, disability, the consequences are alarming! Why do these events continue to occur today, when anesthesia techniques and conditions have advanced so much? Against some eyes and ears in the clinical work, I feel that the reason why many of the events occur, the reason why people feel very sorry, the overall or lack of vigilance, not fully prepared to work, once the event occurs lack of timely and effective response measures, the original may be prevented, timely and effective disposal can be avoided on the trivial, due to lack of preparation and delay resulting in serious consequences. First, first of all, analyze the causes of malignant events: can be broadly divided into several types of problems 1, has foreseen possible problems, but did not pay sufficient attention. Most of the incidents that occurred in some large hospitals belong to this category. These hospitals are not too many experts, technical and facility conditions are not too strong, but the problem is not too low-level. For example, it is already known that the patient may have difficulty with tracheal intubation, yet rapid induction is preferred instead of honest preparation, such as peering into the voice portal under surface anesthesia, such as having facilities such as a guide probe ready, such as preserving deep sedation for spontaneous breathing before intubation with inotropes, etc. Once the intubation difficulties, and will be anxious head sweat, or even repeatedly try to insert resulting in pharyngeal cavity injury bleeding, making it more difficult for others to dispose of. 2, the mind is not prepared for the lack of foresight for possible problems: this situation is more often seen in young people, due to the lack of experience, the lack of foresight for some potential problems risk, the patient as a general situation and routine disposal, once the risk occurs to be caught off guard. Or due to the real lack of experience, mainly seen in primary hospitals, not enough training is the main reason. 3. Inadequate preparation of facilities, drugs, etc. before anesthesia: including: no adequate preoperative assessment, or assessment but inexperienced and unable to predict the risk; due preparation is not done, such as intubation of difficult facilities, multiple catheters of different thickness, laryngeal mask backup; anesthesia machine without inspection to start induction, after induction can not be effective mechanical ventilation; malignant nerve reflex without drug preparation, once the occurrence of Temporary disposal when the heart has stopped. This is on the one hand due to the conditions and occurs mainly in primary hospitals. On the other hand, it is due to overconfidence and over-reliance on the help of anesthesia nurses and other people, who do not check themselves beforehand and desperately argue once the problem arises, mainly seen in large hospitals. 4. Inexperience, improper scheduling, etc.: For example, holidays, nighttime and shift change are the moments when problems are most likely to occur. If an inexperienced physician is arranged to be on duty alone, the second and third line listening shifts are not present, and once a crisis event occurs, it is too late to make a temporary call. This is most common in large hospitals, small and medium-sized hospitals instead because of the strict requirements of hospitals and departments is relatively rare. 5, the institutional mechanism: due to China’s national conditions, many hospitals at present, young physicians may only have a short period of 1 year to carry out preliminary training on the job alone, after 80, after 90 most of the young people are very confident, and even a lot of people working for 1 year has claimed to have what work habits. Although this is shown in the young people, in fact, the responsibility still lies with the department head and the older generation. What should be said is not said, and what should be managed is not cared, forming a bad human environment in the department. At a deeper level, Chinese education, especially undergraduate education, should have a fair evaluation and conclusion, and this will definitely harm Chinese anesthesia. Secondly, let’s talk about how to prepare for some anesthesia accidents: When it comes to the word anesthesia accidents, many people may disagree because most of these so-called accidents are actually predictable, and many of them are even low-level errors of principle. But in this current situation in China, what we can do is really only try to remind everyone to be as prepared as possible, and turn the accident into an expected one can greatly reduce this so-called accident. 1, strengthen training, improve the knowledge and skills of young doctors: there are already areas in China to start standardized training, such as Sichuan Huaxi and Shanghai, is a good thing but there are great difficulties. I think the current situation, we can do is to use the region, including the provincial and municipal regional exchange meetings and other ways, is the only feasible and the most efficient and effective way of training. In this way most anesthesiologists in each county and urban area can have a full understanding of this one issue, and in their work they can be alert enough to the related problems and be fully prepared for the difficulties. 2, make full use of all resources to improve the existing facilities: the work is to be good at what it does, for some problems without adequate facilities is simply impossible to solve. For example, intubation difficulties we can solve many problems if we have a guide probe, but there are many hospitals do not have such things. For the conditions can be used with the help of Wang Tieren’s saying: “conditions to go on, no conditions to create conditions also to go on”. Some things can be made by themselves, such as the probe bar can be solved with a gastric tube with a thin copper wire built in. For example, the laryngoscope should always check the connections for poor electrical conductivity, etc. These do not need to spend a lot of money. 3, strengthen the department’s technical standardization management, requiring all physicians to work in accordance with the specifications. The most common mistake young physicians make is to be overconfident within a few years of work and unaware of the seriousness of the problem. The only solution to this is to strengthen the standardized management, including institutionalized humanistic management, process-oriented technical management and so on. For example, for the use of general anesthesia, fentanyl is one of the most commonly used components of general anesthesia, but some people want to use fentanyl, some want to use remifentanil, some want to use sufentanil, and others want to combine several short-acting, medium-acting and long-acting opioids, which is certainly different, at least the basic process should be specified for general patients how to how, for special patients and how to how, only then is truly standardized management. If a physician says he is accustomed to use what, it is absolutely wrong, is not standardized. 4.Strengthen the construction of the humanistic environment of the department: the anesthesiology department is in an environment where it communicates with various departments every day, and the relationship between them is very complicated, including the relationship with nurses in the operating room, the relationship with surgeons, obstetricians and gynecologists and other surgeons, the relationship with the director of the ward and the leadership of the hospital at all levels of management, and so on. It is really not easy for the department head to be all-rounded. We have seen many hospitals in the garden physicians have great opinions about their own department director, and even abusive attacks. 5, to strengthen their own training, continuous self-learning to improve: in today’s era of massive information, which a person wants to do what technology monopoly and other silly things, then he is really a fool. But how noble your origin, to that developed country to stay like gold plating. Conversely, each person to want to rely on others to help their whole life is also ridiculous, even is a time to help also cost you a lot. At the same time to make full use of us old guys who will die before they die, there must be difficulties to sincerely and honestly ask for advice to learn. In this way you will spend 5 years to get through the trials and tribulations that others spend 10 years to get through, and grow up as quickly as possible.