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      Safety Features in Anaesthesia Machine

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          Abstract

          Anaesthesia is one of the few sub-specialties of medicine, which has quickly adapted technology to improve patient safety. This application of technology can be seen in patient monitoring, advances in anaesthesia machines, intubating devices, ultrasound for visualisation of nerves and vessels, etc., Anaesthesia machines have come a long way in the last 100 years, the improvements being driven both by patient safety as well as functionality and economy of use. Incorporation of safety features in anaesthesia machines and ensuring that a proper check of the machine is done before use on a patient ensures patient safety. This review will trace all the present safety features in the machine and their evolution.

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          Checking anaesthetic equipment 2012: association of anaesthetists of Great Britain and Ireland.

          A. Hartle, E. Anderson, V Bythell … (2012)
          A pre-use check to ensure the correct functioning of anaesthetic equipment is essential to patient safety. The anaesthetist has a primary responsibility to understand the function of the anaesthetic equipment and to check it before use. Anaesthetists must not use equipment unless they have been trained to use it and are competent to do so. A self-inflating bag must be immediately available in any location where anaesthesia may be given. A two-bag test should be performed after the breathing system, vaporisers and ventilator have been checked individually. A record should be kept with the anaesthetic machine that these checks have been done. The 'first user' check after servicing is especially important and must be recorded. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.
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            Adverse anesthetic outcomes arising from gas delivery equipment: a closed claims analysis.

            M F Vistica, Frederick Cheney, Louis Caplan … (1997)
            Anesthesia gas delivery equipment is a potentially important source of patient injury. To better define the contribution of gas delivery equipment to professional liability in anesthesia, the authors conducted an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project. The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims resulting from the use of gas delivery equipment were reviewed for recurrent patterns of injury. Gas delivery equipment was associated with 72 (2%) of 3,791 claims in the database. Death and permanent brain damage accounted for almost all adverse outcomes (n = 55, 76%). Equipment misuse was defined as fault or human error associated with the preparation, maintenance, or deployment of a medical device. Equipment failure was defined as unexpected malfunction of a medical device, despite routine maintenance and previous uneventful use. Misuse of equipment (n = 54, 75%) was three times more common than equipment failure (n = 17, 24%). Misconnects and disconnects of the breathing circuit made the largest contribution to injury (n = 25, 35%). Reviewers judged that 38 of 72 claims (53%) could have been prevented by pulse oximetry, capnography, or a combination of these two monitors. Overall, 56 of 72 gas delivery claims (78%) were deemed preventable with the use or better use of monitors. The year of occurrence for claims involving gas delivery equipment ranged from 1962 to 1991 and did not differ significantly from claims involving other adverse respiratory events. Claims associated with gas delivery equipment are infrequent but severe and continue to occur in the 1990s. Educational and preventive strategies that focus on equipment misuse and breathing circuit configuration may have the greatest potential for enhancing the safety of anesthesia gas delivery equipment.
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              The use of high-fidelity human patient simulation and the introduction of new anesthesia delivery systems.

              Brian Robinson, Jennifer Weller, Charles Caldwell … (2004)
              New anesthesia delivery systems are becoming increasingly complex. Although equipment is involved in a large proportion of intraoperative anesthesia problems (most also involving human error), the current methods of introducing new equipment into clinical practice have not been well studied. We designed a randomized, controlled, prospective study to investigate an alternative method of introducing new anesthesia equipment. Fifteen anesthesiology trainees were randomized to either the standard introduction to a Drager Fabius GS anesthesia delivery machine plus simulated clinical use of the new machine in a high-fidelity human patient simulator (HPS) (Group 1) or to the standard introduction alone (Group 2). We used a questionnaire to seek their opinion on the new equipment, and responses showed that both groups were comparable in their reported confidence to use the new equipment safely. All trainees were then tested in two simulated anesthetic crises with the new machine. Performance was analyzed in terms of time to resolve the emergency, by using analysis of videos by an independent rater. Group 1 resolved both crises significantly faster. HPS allowed us to detect design features that were common sources of error.
              Article 0 comments Cited 6 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Anaesth
                Journal ID (iso-abbrev): Indian J Anaesth
                Journal ID (publisher-id): IJA
                Title: Indian Journal of Anaesthesia
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0019-5049
                ISSN (Electronic): 0976-2817
                Publication date (Print): Sep-Oct 2013
                Volume: 57
                Issue: 5
                Pages: 472-480
                Affiliations
                [1]Department of Anaesthesiology, Global Hospitals, Axon Anaesthesia Associates, Hyderabad, Andhra Pradesh, India
                Author notes
                Address for correspondence: Dr. Subrahmanyam Maddirala, 72, Nagarjuna Hills, Punjagutta, Hyderabad, Andhra Pradesh, India. E-mail: msubrah@ 123456gmail.com
                Article
                Publisher ID: IJA-57-472
                DOI: 10.4103/0019-5049.120143
                PMC ID: 3821264
                PubMed ID: 24249880
                SO-VID: a5704806-d33d-44f0-9973-f27828a33686
                Copyright © Copyright: © Indian Journal of Anaesthesia
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: anaesthesia machine,hypoxia prevention,safety features
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: anaesthesia machine, hypoxia prevention, safety features

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