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Biomedical subjects

R Westhorpe

Publications and source records attributed to R Westhorpe.

At least 19 recordsLinked to original sources
PubMed1998

Influence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator.

OBJECTIVE: Many studies (outcome, epidemiological) have tested the hypothesis that pulse oximetry and capnography affect the outcome of anesthetic care. Uncontrollable variables in clinical studies make it difficult to generate statistically conclusive data. In the present study, we eliminated the variability among patients and operative procedures by using a full-scale patient simulator. We tested the hypothesis that pulse oximetry and capnography shorten the time to diagnosis of critical incidents. METHODS: A simulator was programmed to represent a patient undergoing medullary nailing of a fractured femur under general anesthesia and suffering either malignant hyperthermia, a pneumothorax, a pulmonary embolism or an anoxic oxygen supply. One hundred thirteen anesthesiologists were randomly assigned to one of two groups of equal size, one with access to pulse oximetry and capnography data and the other without. Each anesthesiologist was further randomized to one of the four critical incidents. Each anesthetic procedure was videotaped. The time to correct diagnosis was measured and analyzed. RESULTS: Based on analysis of 91 of the subjects, time to diagnosis was significantly shorter (median of 432 s vs. >480 s) for the anoxic oxygen supply scenario (p = 0.019) with pulse oximetry and capnography than without. No statistical difference in time to diagnosis was obtained between groups for the other three critical incidents. CONCLUSIONS: Simulation may offer new approaches to the study of monitoring technology. However, the limitations of current simulators and the resources required to perform simulator-based research are impediments to wide-spread use of this tool.

Anesthesia, General↗
PubMed1998

The EMO vaporizer.

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Anesthetics, Inhalation↗
PubMed1998

The small inhaler.

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Analgesia, Obstetrical↗
PubMed1997

Logistics of conducting a large number of individual sessions with a full-scale patient simulator at a scientific meeting.

OBJECTIVE: To design and implement the logistics of accommodating a large number of participants in individual, hands-on sessions on a full-scale patient simulator during a major scientific meeting or continuing medical education course. METHODS: We used our method during the 11th World Congress of Anaesthesiologists in Sydney, Australia to facilitate studying the impact of pulse oximetry and capnography on the time taken by anesthesiologists to correctly identify critical incidents on a full-scale patient simulator. Each study participant spent 15 minutes in 4 sections of the study area: the anesthesia and monitoring equipment briefing room, the simulator briefing room, the simulation room and the debriefing room. RESULTS: There were 113 participants during five days (15 during instructor training and 25, 23, 24 and 26 on subsequent exhibit days). We were oversubscribed daily. However, there were 9 no-shows during the 4 days of the study, which generated a participant absence rate of 9.2%. The average number of participants over the 4 days of the study was 24.5 per day compared to our capacity of 27 per day. The feedback we obtained from the participants about the simulation experience and the format of the exercise was positive and enthusiastic. CONCLUSIONS: We have developed a practical and viable method that can be adapted for use at scientific meetings and courses, which improves accessibility of individual, hands-on sessions on full-scale patient simulators to a larger audience than previously attainable. Our method is applicable for continuing medical education courses as well as research purposes in the form of prospective studies during scientific meetings and courses.

Anesthesiology↗
PubMed1997

Ether inhaler, 1847.

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Anesthesia, Inhalation↗