Promoting safe anaesthesia for every child: the SAFETOTS initiative and beyond.

PURPOSE OF THE REVIEW: Paediatric anaesthesia has achieved remarkable progress over recent decades, yet contemporary data reveal that safety remains unevenly distributed across age groups, institutions, and regions of the world.

RECENT FINDINGS: Large observational studies demonstrate persistent perioperative morbidity and mortality, particularly in neonates, infants, and children cared for in resource-limited settings. While these multicentric investigations did not establish a direct causal relationship between anaesthetic management and perioperative morbidity or mortality in paediatric populations, they did reveal a high incidence of critical events related to the conduct of anaesthesia, which, if not diagnosed in time or left uncorrected, could lead to catastrophic outcomes.

SUMMARY: The Safe Anaesthesia for Every Tots (SAFETOTS) initiative focuses on the safe conduct of anaesthesia, maintenance of perioperative physiological stability, alongside organisational and child-centred values in perioperative care. This review explores the current state of and challenges in paediatric anaesthesia safety through the perspective of the SAFETOTS initiative.