Why Use Checklists in Anesthesia
In 2008 the World Health Organization introduced the Surgical Safety Checklist which has since been shown to significantly to reduce anesthesia and surgical morbidity and mortality. Using checklists allow us to more easily accomplish clinical tasks and reduce the chance of an error.
Much of what we do in anesthesia is complex and, to some in the field, somewhat frightening. Checklists give you a cognitive aid that delineates and categorizes essential important tasks and steps, making that complexity less overwhelming to you and your colleagues. Also, checklists help us improve communication among team members and flatten the hierarchy by giving everyone equal responsibility and power to insure the proper sequence of procedures has been performed and confirmed.
The standard checklists used in anesthesia and surgery typically are done as a “time out” before induction of anesthesia, before the surgeon makes the incision and before the patient leaves the OR. You can find free information on checklists used in veterinary anesthesia at the Northa American Veterinary Anesthesia Society Website (www.mynavas.org )and under the resources section of the Association of Veterinary Anaesthetists (www.ava.eu.com).
An example of one checklist is an anesthesia machine checklist that should be performed prior to use of an anesthesia machine on any patient – here is one that can be used quite quickly and easily:
Anesthesia machine turned on
Primary oxygen source checked and confirmed adequate, including backup oxygen
Flowmeters working
Vaporizer is full and filler port closed
Leak test confirmed successful for circuit being used on your patient
Pop-off (APL) valve working and in the open position
Scavenging system checked and working
Monitoring equipment turned on, warmed up, working
Endotracheal tubes of appropriate size and length available and cuffs checked
Laryngoscope with appropriate blade available and light is working
You should develop your own anesthesia machine, pre-induction, pre-surgery, and post-surgery checklists based on your own practice. Once implemented, you will find better peace of mind when performing anesthesia with the knowledge that you and your team have taken steps to reduce some of the complexity of anesthesia, allowing you to focus more on patient care and the task at hand.