ABSTRACT
This chapter provides an overview of the analogy between aviation and anaesthesia and shows the similarities between the two systems. It suggests that aviation is the importance of the timeline when investigating an anaesthetic or surgical-related incident or accident and presents a new model for system safety that incorporates this change in concept. The chapter describes the Winnipeg Fatality Inquiry which facilitates review of all the contributory factors and that all those who are part of the anaesthetic, medical and aviation systems remember that 'quality is no accident'. It explores that the Inquiry in Winnipeg has the potential to do for pediatric cardiac surgery, and medicine in general, what the Dryden Inquiry did for aviation. Using chronologically derived information, both aviation and anaesthesia have established databases to record the results, the analysis and evaluation of accident investigation. In both systems, anaesthetist and pilot are the central component of a man-machine interaction, with the operator as a processor of information.
