Anesthesiology Research Today is a free monthly online journal that collates and summarizes the latest research about Anesthesiology, including details on clinical anesthesiology, evidence based practice, techniques.

Passage of pathogenic microorganisms through breathing system filters used in anaesthesia and intensive care.

Scott DH, Fraser S, Willson P, Drummond GB, Baillie JK

Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK. david.scott@ed.ac.uk

SUMMARY: Invasive ventilation poses a risk of respiratory infection that can be drug-resistant. One means of reducing transmission of infection is the use of a breathing system filter. Filters are intended to be used with dry gas. Current international standards do not require that filters prevent bacterial transfer when wet. It is not known whether microorganisms pass through wet filters, but theory predicts that this might occur. We tested six filters from three different manufacturers. We passed a suspension of microorganisms through the filters using the least pressure necessary, and incubated a sample of the filtrate on blood agar. All the filters tested allowed free passage of both Candida albicans and coagulase-negative staphylococci. The median (IQR [range]) pressure required for fluid to flow across the filter varied greatly between different filter types (20 (0-48 [0-138]) cmH(2)O). We conclude that even large microorganisms pass across moist breathing system filters in conditions that are found in clinical practice.

Published 20 July 2010 in Anaesthesia, 65(7): 670-3.
Full-text of this article is available online (may require subscription).

Articles on Anesthesiology published 20 July 2010:

Tracheal intubation following training with the GlideScope compared to direct laryngoscopy.   Anaesthesia, 65(7): 674-8.

SUMMARY: Tracheal intubation using direct laryngoscopy has a high failure rate when performed by untrained medical personnel. This study compares tracheal intubation following direct laryngoscopy by inexperienced medical students when initially trained by using either the GlideScope, a video assisted laryngoscope, or a rigid (Macintosh) laryngoscope. Forty-two medical students with no previous experience in tracheal intubation were randomly divided into two equal groups to receive training with ... [Abstract] [Full-text]

Articles on Anesthesiology published 25 June 2010:

Control chart monitoring of the numbers of cases waiting when anesthesiologists do not bring in members of call team.   Anesth Analg, 111(1): 196-203.

INTRODUCTION: An anesthesia group staffing agreement with a hospital often specifies the minimum number of operating rooms (ORs) to be covered during evening or weekend hours. Frequently, 1 anesthesiologist works in-house and others take call from home, coming in if multiple cases are waiting to be done. The anesthesiologist in-house sometimes does not bring in colleagues from home when the number of ORs he can supervise is less than the number specified in the agreement with the hospital ... [Abstract] [Full-text]

Articles on Anesthesiology published 16 June 2010:

Beyond monitoring: distributed situation awareness in anaesthesia.   Br J Anaesth, 105(1): 83-90.

Situation awareness (SA) is one of the essential non-technical skills for effective and safe practice in high-risk industries, such as healthcare; yet, there is limited research of its significance in anaesthetic practice. In this paper, we review this scant research that focuses on SA as patient monitoring alone and advocate for a more comprehensive view of SA in anaesthetic practice and training that extends beyond monitoring, namely, a distributed cognition approach. We identify further ... [Abstract] [Full-text]

Critical incident reporting and learning.   Br J Anaesth, 105(1): 69-75.

The success of incident reporting in improving safety, although obvious in aviation and other high-risk industries, is yet to be seen in health-care systems. An incident reporting system which would improve patient safety would allow front-end clinicians to have easy access for reporting an incident with an understanding that their report will be handled in a non-punitive manner, and that it will lead to enhanced learning regarding the causation of the incident and systemic changes which will ... [Abstract] [Full-text]

Interaction between anaesthetists, their patients, and the anaesthesia team.   Br J Anaesth, 105(1): 60-8.

Communication is a key skill for anaesthetic practice. The 'non-informational' aspects of communication, such as non-verbal elements and the degree to which the style of communication reflects the implied relationship between the sender and the recipient, are relevant to interactions both between anaesthetists and patients and to interactions with other members of staff in the team. Communication and interaction between members of the anaesthesia team in isolation has received less attention ... [Abstract] [Full-text]

Patient safety: latent risk factors.   Br J Anaesth, 105(1): 52-9.

The person-centred analysis and prevention approach has long dominated proposals to improve patient safety in healthcare. In this approach, the focus is on the individual responsible for making an error. An alternative is the systems-centred approach, in which attention is paid to the organizational factors that create precursors for individual errors. This approach assumes that since humans are fallible, systems must be designed to prevent humans from making errors or to be tolerant to those ... [Abstract] [Full-text]

Lessons from the battlefield: human factors in defence anaesthesia.   Br J Anaesth, 105(1): 9-20.

Anaesthetists in the Defence Medical Services spend most of their clinical time in the National Health Service and deploy on military operations every 6-18 months. The deployed operational environment has a number of key differences particularly as there is more severe trauma than an average UK hospital and injury patterns are mainly due to blast or ballistics. Equipment may also be unfamiliar and there is an expectation to be conversant with specific standard operating procedures. ... [Abstract] [Full-text]

Anaesthetists' non-technical skills.   Br J Anaesth, 105(1): 38-44.

This review presents the background to the development of the anaesthetists' non-technical skills (ANTS) taxonomy and behaviour rating tool, which is the first non-technical skills framework specifically designed for anaesthetists. We share the experience of the anaesthetists who designed ANTS in relation to applying it in a department of anaesthesia, using it in a simulation centre, and the process of introducing it to the profession on a national basis. We also consider how ANTS is being ... [Abstract] [Full-text]

© 2005-2010 Anesthesiology Research Today. All Rights Reserved.