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PubMed · 16913466

Anesthesia systems.

Abstract

This Evaluation presents ECRI's detailed findings for three newly tested anesthesia systems and updated ratings for three previously evaluated ones. The study focuses on models intended for the full range of inpatient surgical applications. That is, we consider whether and how well the systems--three supplied by Datex-Ohmeda and three supplied by Draeger Medical--can meet the needs of patients covering a wide range of ages, sizes, and conditions. We also consider the adequacy of the systems' safety features, the comprehensiveness of their pre-use checks, and ease of use. We found that all the evaluated units generally perform well, displaying comparable accuracy and consistency of delivery when similarly equipped (e.g., with comparable ventilation modes). However, all the systems also have critical limitations associated with their pre-use check procedures. Several units also exhibit problems with the handling of important alarms under certain conditions. Our ratings will help guide healthcare facilities both when selecting a model and when determining which options to purchase. In several cases, models that are otherwise appropriate for use are rated Not Recommended for purchase if they are not equipped with certain options. And in one case, we rate a unit Unacceptable for purchase if it is not equipped with a safety feature that can help reduce the risk of surgical fires.

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2006. Anesthesia systems.. https://pubmed.ncbi.nlm.nih.gov/16913466/

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Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees.

BACKGROUND AND OBJECTIVE: We surveyed delegates at the Group of Anaesthetists in Training (UK) meeting to investigate evidence of a training-gap (number of fibreoptic intubations believed to bestow competence vs. number actually performed). METHODS: Questionnaires were distributed to and collected from delegates in person. Questions covered six areas, including experience of fibreoptic intubation and cricothyrotomy, fibreoptic intubation as a specialist skill and ethical issues. RESULTS: We received 221 replies (76%). All trainees believed competence to be achievable with 10 intubations (interquartile range (IQR) 10-20); the median number performed was 2 (IQR 0-4). This was statistically significant for the groups' senior house officers, 1st and 2nd year registrars and 3rd and 4th year registrars; P < 0.0001. Many final year trainees (12/20, 60%) also failed to achieve their competency target. Few trainees had seen or performed any cricothyrotomies (medians 0, IQRs 0-1 and 0-0). Most (195/208, 94%) believed that fibreoptic intubation was a core skill and 199/212 (94%) believed that all should be competent by completion of training. Ten percent (n = 208) felt it unethical to perform an awake training intubation with full consent and 10% believed it acceptable without explanation. Most (82.7%) would fibreoptically intubate an asleep patient (requiring intubation) without consent. CONCLUSION: Trainees reported a gap between their perception of competence and achievement in awake fibreoptic intubation. Simple and complex simulations and structured training programmes may help. Anaesthetists must address the ethics of clinical training in advanced airway management.

Anesthesiology↗