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PubMed · 9127778

Feedback control in anaesthesia.

A J Asbury
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Abstract

This review considers the some of the methods of automatic control which are usable in medicine. The features of each type of control system are explained and the advantages and disadvantages summarised. The author has attempted to maintain a balance between what is possible with the excellence of modern engineering, and what is feasible in the clinical area, and practical when working with patients. The problem of lack of knowledge of an individual patient is emphasised, as is the potential of fuzzy logic methods in the future.

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AnesthesiologyDecision Making, Computer-AssistedFeedbackFuzzy LogicHumansInfusions, IntravenousModels, BiologicalMonitoring, IntraoperativeRespiration, ArtificialJournal ArticleReview

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A J Asbury. 1997. Feedback control in anaesthesia.. https://doi.org/10.1007/bf03356572

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PubMed2007

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.

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