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Inadequate Preanesthesia Equipment Checks In A Simulator

Allysan Armstrong-Brown, J. Devitt, M. Kurrek, M. Cohen
Published 2000 · Medicine

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Purpose: To assess how completely anesthesiologists check their machinery and equipment before use, and to determine what influence seniority, age and type of practice may have on checking practices.Methods: One hundred and twenty anesthesiologists were videotaped during a simulated anesthesia session. Each participant was scored by an assessor according to the number of items checked prior to the induction of anesthesia. A checklist of 20 items derived from well-publicized, international standards was used.Results: Participants were grouped according to their type of practice. Overall, mean scores were low. The ideal score was 20. There were no differences among university anesthesiologists (mean score 10.1, standard deviation 4.3), community anesthesiologists (7.5±4.3) and anesthesia residents (9.0±3.8). Each of these groups scored, on average, better than medical students (3.6±3.7) (P<0.05). Neither age (r=0.15,P>0.1) nor number of years in practice (r=−0.18,P>0.1) correlated with score.Conclusions: Our study suggests that the equipment-checking practices of anesthesiologists require considerable improvement when compared with national and international standards. Possible reasons for this are discussed and some remedial suggestions are made.RésuméObjectif: Évaluer le degré de vérification des appareils faite par les anesthésiologistes avant de les utiliser et déterminer l’influence de l’ancienneté, de l’âge et du type de pratique sur les habitudes de vérification.Méthode: Cent vingt anesthésiologistes ont été filmés sur vidéocassette pendant une session d’anesthésie simulée. Chaque participant a été coté par un évaluateur selon le nombre d’éléments vérifiés avant l’induction de l’anesthésie. On a utilisé une liste de 20 éléments dérivée de normes internationales bien connues.Résultats: Les participants ont été regroupés selon leur type de pratique. Globalement, les scores moyens ont été faibles. Le meilleur score a été de 20. Il n’y avait pas de différence entre les anesthésiologistes spécialistes (moyenne de 10,1 et écart type de 4,3). les anesthésiologistes omnipraticiens (7,5±4,3) et les résidents en anesthésie (9,0±3,8). Chacun de ces groupes a affiché des scores moyens meilleurs que ceux des étudiants de médecine (3,6±3,7) (P<0,05). Il n’y avait pas de corrélation entre l’âge (r=0,15,P>0,1) ou le nombre d’années d’exercice (r=−0,18,P>0,1) et le score obtenu.Conclusion: Notre étude permet de présumer que les habitudes de vérification de l’équipement des anesthésiologistes, comparées aux normes nationales et internationales, doivent être de beaucoup améliorées. Les causes possibles de cette situation sont examinées et certaines solutions sont proposées.
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