| Influence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator. | |
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MedLine Citation:
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PMID: 9951756 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Many studies (outcome, epidemiological) have tested the hypothesis that pulse oximetry and capnography affect the outcome of anesthetic care. Uncontrollable variables in clinical studies make it difficult to generate statistically conclusive data. In the present study, we eliminated the variability among patients and operative procedures by using a full-scale patient simulator. We tested the hypothesis that pulse oximetry and capnography shorten the time to diagnosis of critical incidents. METHODS: A simulator was programmed to represent a patient undergoing medullary nailing of a fractured femur under general anesthesia and suffering either malignant hyperthermia, a pneumothorax, a pulmonary embolism or an anoxic oxygen supply. One hundred thirteen anesthesiologists were randomly assigned to one of two groups of equal size, one with access to pulse oximetry and capnography data and the other without. Each anesthesiologist was further randomized to one of the four critical incidents. Each anesthetic procedure was videotaped. The time to correct diagnosis was measured and analyzed. RESULTS: Based on analysis of 91 of the subjects, time to diagnosis was significantly shorter (median of 432 s vs. >480 s) for the anoxic oxygen supply scenario (p = 0.019) with pulse oximetry and capnography than without. No statistical difference in time to diagnosis was obtained between groups for the other three critical incidents. CONCLUSIONS: Simulation may offer new approaches to the study of monitoring technology. However, the limitations of current simulators and the resources required to perform simulator-based research are impediments to wide-spread use of this tool. |
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Authors:
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S Lampotang; J S Gravenstein; T Y Euliano; W L van Meurs; M L Good; P Kubilis; R Westhorpe |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of clinical monitoring and computing Volume: 14 ISSN: 1387-1307 ISO Abbreviation: J Clin Monit Comput Publication Date: 1998 Jul |
Date Detail:
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Created Date: 1999-04-22 Completed Date: 1999-04-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9806357 Medline TA: J Clin Monit Comput Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 313-21 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of Florida College of Medicine, University of Florida Brain Institute, Gainesville 32610-0254, USA. sem@anest4.anest.ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, General Capnography* Computer Simulation Humans Intraoperative Complications / diagnosis*, epidemiology Oximetry* Pilot Projects Random Allocation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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