McHugh Gretl A, Pollard Brian J, Hooda Sarla, Thoms Gavin Mm
School of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Indian J Anaesth. 2011 May;55(3):235-41. doi: 10.4103/0019-5049.82662.
The overall goal of the global oximetry (GO) project was to increase patient safety during anaesthesia and surgery in low and middle income countries by decreasing oximetry costs and increasing oximetry utilisation. Results from the overall project have been previously published. This paper reports specifically on pilot work undertaken in four hospitals in one Indian State. The aim of this work was to assess the impact of increasing oximetry provision in terms of benefits to anaesthetists and in the identification of patient problems during anaesthesia, to identify training needs and to explore perceptions regarding barriers to more comprehensive oximetry coverage. Data collection was by interview with hospital staff, use of a log-book to capture data on desaturation episodes and a follow-up questionnaire at 10 months after the introduction of additional oximeters. Increasing oximetry utilisation in the four hospitals was viewed positively by the anaesthetic staff and enabled improvement in monitoring patients. Of the 939 monitored patients studied, 214 patients (23%) experienced a total of 397 desaturation episodes. For nearly half of the patients undergoing caesarean section under regional anaesthesia following a desaturation event supplementary oxygen was required. In 53 of the 379 female sterilisations (14%) desaturation episodes occurred and in eight patients, there were 17 episodes of desaturation due to obstruction. In the recovery room, 91 of the 939 patients were monitored using the oximeters with 12 patients (13%) requiring oxygen. This study has highlighted that pulse oximetry must be used even in patients having surgical procedures or caesarean section under regional or local anaesthesia as these procedures are associated with hypoxic episodes. Anaesthetists must ensure they are complying with the Indian Society of Anaesthesiologists monitoring standards for anaesthesia and ensure patients are monitored by pulse oximetry.
全球脉搏血氧饱和度监测（GO）项目的总体目标是，通过降低脉搏血氧饱和度监测成本并提高其利用率，在低收入和中等收入国家提高麻醉和手术期间的患者安全性。整个项目的结果已在之前发表。本文具体报告了在印度一个邦的四家医院开展的试点工作。这项工作的目的是评估增加脉搏血氧饱和度监测设备带来的影响，包括对麻醉医生的益处以及在麻醉期间识别患者问题方面的影响，确定培训需求，并探讨对更全面的脉搏血氧饱和度监测覆盖存在的障碍的看法。数据收集方式包括与医院工作人员进行访谈、使用日志记录血氧饱和度下降事件的数据，以及在引入额外脉搏血氧饱和度监测仪10个月后进行随访问卷调查。麻醉工作人员对四家医院脉搏血氧饱和度监测利用率的提高持积极看法，这有助于改善对患者的监测。在研究的939名接受监测的患者中，有214名患者（23%）总共经历了397次血氧饱和度下降事件。在区域麻醉下进行剖宫产手术的患者中，近一半在发生血氧饱和度下降事件后需要补充氧气。在379例女性绝育手术中，有53例（14%）发生了血氧饱和度下降事件，8名患者因梗阻发生了17次血氧饱和度下降事件。在恢复室，939名患者中有91名使用脉搏血氧饱和度监测仪进行监测，其中12名患者（13%）需要吸氧。这项研究强调，即使是接受区域或局部麻醉的手术或剖宫产患者，也必须使用脉搏血氧饱和度监测，因为这些手术与缺氧事件有关。麻醉医生必须确保他们遵守印度麻醉医师协会的麻醉监测标准，并确保患者接受脉搏血氧饱和度监测。
