Role of Monitoring Devices in Prevention of Anesthetic Mishaps

Tinker, John H.; Dull, David L.; Caplan, Robert A.; Ward, Richard J.; Cheney, Frederick W.

doi:10.1097/00000542-198910000-00010

Cited by 258 publications

(75 citation statements)

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“…Considering the uncertainty about deleterious effects of transient, short lasting hypoxaemia routine use of pulse oximetry is advocated for patient transfer to the PACU. Analysis of anaesthetic-related closed malpractice claims demonstrated that hypoxaemia, resulting in desaturation, was a major cause for morbidity and mortality during and following procedures under general anaesthesia [1,2]. More recent data confirm the deleterious effects hypoxaemia may have on patient outcome [3,4].…”

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confidence: 99%

Impact of medical training and clinical experience on the assessment of oxygenation and hypoxaemia after general anaesthesia: an observational study

Aust

Kranke

Eberhart

et al. 2014

J Clin Monit Comput

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In Germany it is common practice to use pulse oximetry and supplementary oxygen only on request in patients breathing spontaneously transferred to the post-anaesthesia care unit (PACU) following surgery under general anaesthesia. The main aim was to study the influence of medical training and clinical experience on assessing SpO(2) and detecting hypoxaemia in these patients. The second aim was to do a preliminary assessment whether this practice can be found in countries other than Germany. Anaesthetists, nurses and medical students estimated SpO(2) in patients breathing room air at the end of transfer to the PACU following surgery (including all major surgical fields) under general anaesthesia. Estimated SpO(2) was compared to SpO(2) measured by pulse oximetry. A survey was carried out among European anaesthesists concerning the use of pulse oximetry and supplementary oxygen during patient transfer to the PACU. Hypoxaemia (SpO(2) < 90 %) occurred in 154 (13.5 %) out of 1,138 patients. Anaesthetists, nurses, and medical students identified only 25, 23, and 21 patients of those as being hypoxaemic, respectively. Clinical experience did not improve detection of hypoxaemia both in anaesthetists (p = 0.63) and nurses (p = 0.18). Use of pulse oximetry and supplemental oxygen during patient transfer to the PACU in European countries differs to a large extent. It seems to be applied only on request in many hospitals. Considering the uncertainty about deleterious effects of transient, short lasting hypoxaemia routine use of pulse oximetry is advocated for patient transfer to the PACU.

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mentioning

confidence: 99%

Impact of medical training and clinical experience on the assessment of oxygenation and hypoxaemia after general anaesthesia: an observational study

Aust

Kranke

Eberhart

et al. 2014

J Clin Monit Comput

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“…Dementsprechend kamen die in den letzten Jahren publizierten systematischen Übersichtsarbeiten, die weitestgehend auf Daten der Untersuchung von Moller et al basieren, zu den Schlussfolgerungen, dass durch die Pulsoxymetrie zwar eine Hypoxämie detektiert werden kann, es allerdings keine Evidenz dafür gibt, dass dadurch das Ergebnis für die Patienten nach Anästhesie beeinflusst wird. Ferner kommen Pedersen et al wiederholt zu dem Schluss, dass es unklar ist, ob die routinemäßige, kontinuierliche, perioperative, pulsoxymetrische Überwa-chung überhaupt mit einem Nutzen hinsichtlich der Versorgungsqualität der Patienten einhergeht [36,38,48].…”

Section: Klinische Relevanz Transienter Hypoxämienunclassified

Hypoxämie nach Allgemeinanästhesie

et al. 2012

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The use of opioids and relaxants with short duration of action may have favorable effects on preventing hypoxemia and decreases of S(p)O(2). These measures will, however, not be sufficient to solve this problem because the highest risk factors for hypoxemia are patient-related. Despite knowing risk factors for oxygen desaturation, it is currently not possible to reliably predict which patients will become hypoxemic or have a decrease of S(p)O(2). Therefore, transportation of patients breathing room air from the OR to the PACU directly after GA without use of PO or supplemental oxygen seems to be questionable in terms of patient safety.

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“…It was determined that 31.5 % of the ne gative outcomes could have been prevented by use of additional monitors. Th e authors concluded that monitoring with adequate thresholds appeared able to improve patient outcomes [6]. Cooper e t al.…”

Section: Introductionmentioning

confidence: 99%