Simulating equipment failures can be useful to hone anesthesia providers' skills

If anesthesia equipment fails during an operation, the anesthesia provider is expected to fix it-before the failure creates a crisis. If the malfunction is not corrected rapidly, a patient could experience intraoperative oxygen deficiency, hypoventilation (reduced rate and depth of breathing), or awareness during surgery. In a recent study, a curriculum of simulated equipment-related failures was used to evaluate anesthesia residents' skills, identify individual residents' strengths and weaknesses, and detect gaps in training among the trainees. David J. Murray, M.D., from the Washington University School of Medicine, and colleagues gave 56 anesthesia residents 5 minutes to detect and correct equipment problems in eight scenarios. These included tasks the residents found easy, such as managing a blocked endotracheal tube, and tasks that challenged them, such as managing an overdose of inhaled anesthetic. As expected, the 12 first-year residents did not perform as well as the 14 third- and 16 fourth-year residents.

For example, more senior residents corrected the equipment failure more rapidly than junior residents. Thus, skill in managing equipment failures is obtained through training, the authors suggest. Average scores were similar for the third- and fourth-year residents, indicating that residents' skills are maintained but do not improve with more experience. The authors suggest that this stasis may be due to the absence of training opportunities and the infrequent occurrence of anesthesia equipment failures in the usual practice settings. This study was funded in part by the Agency for Healthcare Research and Quality (HS16652). See "Management of anesthesia equipment failure: A simulation-based resident skill assessment," by William B. Waldrop, M.D., David J. Murray, John R. Boulet, Ph.D., and Joseph F. Kras, D.D.S., M.D., in the August 2009 Anesthesia and Analgesia 109(2), pp. 426-433.

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