TAILIEUCHUNG - Safer Surgery part 41

Safer Surgery part 41. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 374 Safer Surgery Time min -10 1st saliva sample pre-stress value Start of ergospirometry 5 min rest Briefing of scenario 0 Start of scenario Pre-oxygenation RSI classic RSI controlled 10 2nd saliva sample first stress value 3 min rest End of ergospirometry 20 3rd saliva sample second stress value 40 4th saliva sample post-stress value Questionnaire End of trial Figure Flow chart for simulated scenario and stress measurement exposed to highly standardized conditions. However if complications occur the candidates are entitled to leave the algorithms for RSI classic and RSI controlled and act as they would do in clinical reality. Observation of Unsafe Actions and Critical Events The observation of unsafe actions and critical events is well established for human factor research using simulator environments Gaba 1992 Gaba and Howard 2002 Howard et al. 2003 Overly et al. 2007 . In this study we aim to evaluate a clinical guideline applied to paediatric simulation we are venturing into virtually unexplored territory. We record unsafe actions and critical events using a checklist. Simulator-Based Evaluation of Clinical Guidelines in Acute Medicine 375 These are defined as follows oxygen saturation SpO2 90 percent heart rate 80 beats per min forced mask ventilation with airway pressure PAW 20 cm H2O esophageal or endobronchial intubation and more than one intubation attempt. Stress Measurement Our model comprises stress measurement by continuous ergospirometry analyses of cortisol and alpha-amylase in saliva and a brief post-stress questionnaire. Ergospirometry We measure cardiorespiratory stress by ergospirometry using a Cortex Metamax 3 B Cortex Biophysik see Figures and . This portable ergospirometry device with face mask comes combined with a Polar T 41 Polar Electro heart rate meter. The following parameters are collected respiratory rate RR minute volume MV oxygen consumption VO2 carbon dioxide production VCO2 and heart rate HR . VO2 measurement is .

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