Anesthesia Clinical Trial
Official title:
Checkout Procedure Before Airway Practices To Provide Clinical Practice With Video Based Feedback
Video-assisted feedback (VAF) is an educational method used by educators in various areas of medicine. It is possible to gain technical and non-technical skills for practical applications such as cardiopulmonary resuscitation and surgical procedures . VAF is an objective proof of an individual's performance because by giving feedback it provides non debatable, accurate, real-time data. By allowing awareness on certain issues it helps correcting the mistakes. Studies have shown improvement in clinical skills after VAF
Video-assisted feedback (VAF) is an educational method used by educators in various areas of
medicine. It is possible to gain technical and non-technical skills for practical
applications such as cardiopulmonary resuscitation and surgical procedures . VAF is an
objective proof of an individual's performance because by giving feedback it provides non
debatable, accurate, real-time data. By allowing awareness on certain issues it helps
correcting the mistakes . Studies have shown improvement in clinical skills after VAF .
Inaccurate or incomplete control of anesthesia equipment before use is associated with
serious postoperative morbidity and mortality risk. For this reason, a number of control
methods have been developed before the anesthesia application. This is one of these methods
that checklists are created and repeated in intermittent periods.
American society of anesthesiologists (ASA) published a guideline to improve patient safety
in 2008 . This guideline is summarized as mentioned below.
ASA Checklist:
1.Verify Auxiliary Oxygen Cylinder and Self-inflating Manual Ventilation Device are Available
& Functioning 2: Verify patient suction is adequate to clear the airway 3: Turn on anesthesia
delivery system and confirm that ac power is available 4: Verify availability of required
monitors, including alarms. 5: Verify that pressure is adequate on the spare oxygen cylinder
mounted on the anesthesia machine 6: Verify that the piped gas pressures are ≥ 50 psig 7:
Verify that vaporizers are adequately filled and, if applicable, that the filler ports are
tightly closed. 8: Verify that there are no leaks in the gas supply lines between the
flowmeters and the common gas outlet 9: Test scavenging system function. 10: Calibrate, or
verify calibration of, the oxygen monitor and check the low oxygen alarm.
11: Verify carbon dioxide absorbent is not exhausted 12: Breathing system pressure and leak
testing. 13: Verify that gas flows properly through the breathing circuit during both
inspiration and exhalation.
14: Document completion of checkout procedures. 15: Confirm ventilator settings and evaluate
readiness to deliver anesthesia care. (ANESTHESIA TIME OUT)
Ten anesthesia residents will be included in this study. Preoperative evaluation in terms of
general anesthesia will be completed for a patient before anesthesia induction. After
receiving informed consent from the patient resident will complete the preparations by
checking the above-mentioned list (anesthesia machine, operating room desk, monitorization
methods, aspirator systems, operating room gas systems, waste systems and other anesthesia
equipment) then induction will be started. All these steps will be recorded with a camera
system. Once the anesthetic application is completed and all stages are recorded, the video
records will be evaluated in terms of ASA guideline. Before the second phase of the study,
the resident will be informed about the guideline by a staff. Then induction of general
anesthesia in another patient will be recorded at all stages. Once the anesthesia application
is complete, the camera record will be monitored. Differences and developments or possible
similar mistakes between the records will be discussed. After evaluating the records -twice
for each resident- the applicability and effectiveness of the VAF training course will be
investigated in the direction of the results of 20 records, before and after VAF.
The aim of the study is to assess the compliance of anesthesiology and reanimation residents
with the ASA guideline in Kocaeli Derince Training and Research Hospital.
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