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PubMed · 8345374

A reference system in clinical anesthesia.

G Martens·C L Zapf
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Abstract

We have developed, as a pilot project, a hypertext-based reference system for anesthesia in a neurosurgical clinic. The intention is to give passive decision support prior to the operation. The information is presented according to the different needs and knowledge levels of the anesthesiologists. Therefore, with the aid of a simple and universal user interface (mouse and screen keys, no keyboard) the information is structured from basic to more detailed information. To complete the operation-related material the system also offers relevant data from the "anesthesia-related background knowledge" (pre-existing diseases, drugs, and medication, etc.). As an example, a short path through the system is shown to illustrate the presentation and linkage of information.

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AnesthesiologyHumansInformation SystemsPilot ProjectsJournal Article

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G Martens, C L Zapf. 1993. A reference system in clinical anesthesia.. https://doi.org/10.1007/bf01617030

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Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees.

BACKGROUND AND OBJECTIVE: We surveyed delegates at the Group of Anaesthetists in Training (UK) meeting to investigate evidence of a training-gap (number of fibreoptic intubations believed to bestow competence vs. number actually performed). METHODS: Questionnaires were distributed to and collected from delegates in person. Questions covered six areas, including experience of fibreoptic intubation and cricothyrotomy, fibreoptic intubation as a specialist skill and ethical issues. RESULTS: We received 221 replies (76%). All trainees believed competence to be achievable with 10 intubations (interquartile range (IQR) 10-20); the median number performed was 2 (IQR 0-4). This was statistically significant for the groups' senior house officers, 1st and 2nd year registrars and 3rd and 4th year registrars; P < 0.0001. Many final year trainees (12/20, 60%) also failed to achieve their competency target. Few trainees had seen or performed any cricothyrotomies (medians 0, IQRs 0-1 and 0-0). Most (195/208, 94%) believed that fibreoptic intubation was a core skill and 199/212 (94%) believed that all should be competent by completion of training. Ten percent (n = 208) felt it unethical to perform an awake training intubation with full consent and 10% believed it acceptable without explanation. Most (82.7%) would fibreoptically intubate an asleep patient (requiring intubation) without consent. CONCLUSION: Trainees reported a gap between their perception of competence and achievement in awake fibreoptic intubation. Simple and complex simulations and structured training programmes may help. Anaesthetists must address the ethics of clinical training in advanced airway management.

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