Anaesthetic machine checking guidelines: have we improved our practice?

Abstract

Background and objectives: This study follows up an initial audit in 1992 indicating that anaesthetic machine checking practices were often incomplete. The aims were to ascertain if there has been any improvement during this period with special reference to the latest guidelines.

Methods: Following the Association of Anaesthetists of Great Britain and Ireland machine checking guidelines, a structured questionnaire, was used to interview 41 anaesthetists in the South West region on one particular day.

Results: Despite 80% of subjects stating that they had read the latest guidelines recently, only one undertook a complete check and 39/41 (95%) performed partial checks (omitting one or more steps in the guidelines). Steps most commonly omitted were additional monitoring, ventilator function, availability of an alternative means of ventilation and function of ancillary equipment such as laryngoscopes. Only 5/41 subjects performed any check between cases. Several of these checks have been introduced in the 2004 guidelines.

Conclusions: Although there has been a significant increase in the proportion of anaesthetists undertaking machine checks since 1992 (P = 0.0007), we conclude that machine checking guidelines are still poorly followed, with checks specific to the latest guidelines most likely to be omitted.