Anesthesia equipment and their chain of survival

Abstract

Objectives: Anesthesia is a technology driven specialty, technological advancement in anesthesia and monitoring equipment has made sophisticated surgery possible. Safe anesthesia is possible when machines are in good condition. The chain of survival as used by the International Liaison Committee on Resuscitation refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest. A similar chain can be applicable to anesthetic equipment for optimal patient care. Early acquisition of appropriate equipment, appropriate training of end users, prompt preventive maintenance, timely repair, and replacement at the end of the equipment lifespan. In 2002, the Federal Government of Nigeria (FGN) commissioned a project to refurbish eight teaching hospitals which was later upgraded to 14. This paper assessed the functional status of 10 frequently used equipment in anesthesia and intensive care units among the beneficiaries. Material and Methods: A structured questionnaire was sent to heads of anesthesia departments in the 14 beneficiary hospitals of the FGN/VAMED intervention. They reported on the status of 10 equipment commonly used by anesthetists in the operating rooms and intensive care units. Results: All hospitals had the equipment installed in the past 7–14 years with end user training on all the equipment, biomedical engineers were available in the immediate post-installation period. There has been no routine scheduled preventive maintenance of the equipment. Faulty equipment are being used in all the hospitals, 54.6% of the installed equipment are spoilt and no longer in use. The weakest link in the equipment chain of survival is the absence of preventive maintenance. Conclusion: Routine scheduled preventive maintenance and the constant availability of trained and skillful biomedical engineers will no doubt increase the lifespan of anesthetic equipment.

International facets of the ‘chain of survival’ for out-of-hospital and in-hospital cardiac arrest – A scoping review

“…Aside from concepts originally related to CPR, other versions or adaptations of the chain of survival which are not directly related to CPR were found, 14 , 16 , 17 , 19 , 20 , 21 , 22 , 23 , 28 , 29 , 33 , 34 , 35 , 37 , 38 , 40 , 41 , 43 , 45 , 46 , 47 , 52 , 53 for example for specific conditions like trauma 14 , 19 , 23 and severe haemorrhage, 40 land mine incidents, 46 stroke, 41 , 53 ST-elevation myocardial infarction, 20 , 22 drowning, 16 , 34 septic shock, 28 complicated deliveries, 45 occasions and situations (pandemics, 21 , 33 events, 38 terror attacks, 43 chemical/biological/radiological/nuclear incidents, 17 and industrial incidents 37 ). Variations which re-thought the concept include the “survival ladder” (each step leads closer to success), 29 or a “chain of survival behaviours” in first aid (defining domains of first aid education).…”

“…Variations which re-thought the concept include the “survival ladder” (each step leads closer to success), 29 or a “chain of survival behaviours” in first aid (defining domains of first aid education). 52 As peculiarities, there was even an animal chain of survival for veterinary patients, 35 and one for anaesthesia equipment, 47 whereas the latter touches the important point of scarce resource settings.…”

“…After data extraction, the reviewers met and reached a consensus on how to categorize the ideas within the articles included. We thus sorted the publication types into subgroups that were most suitable and internationally recognized (even though a specific journal may have classified a publication differently, e.g., “special report”), and thus report on four abstracts, 13 , 14 , 15 , 16 two commentaries, 17 , 18 five editorials, 19 , 20 , 21 , 22 , 23 ten letters, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 five concepts, 34 , 35 , 36 , 37 , 38 three reviews, 39 , 40 , 41 four statements, 1 , 42 , 43 , 44 six reports of original research, 45 , 46 , 47 , 48 , 49 , 50 and four guidelines. 4 , 51 , 52 , 53 We further grouped the publications ( Supplementary Table S1 ) into “novel kinds of the concept related to resuscitation” ( n = 8), 1 , 4 , 18 , 30 , 31 , 32 , 49 , 51 “novel kinds of the concept not directly related to resuscitation” ( n = 23), 14 , 16 , 17 , 19 , 20 , …”