Riveros Perez Efrain, Jimenez Enoe, Albo Camila, Sanghvi Yashi, Yang Nianlan, Rocuts Alexander
Assistant Professor, Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, USA.
Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.
Anesthesiol Res Pract. 2019 Jul 21;2019:5914305. doi: 10.1155/2019/5914305. eCollection 2019.
Anesthesia providers may need to interpret the output of vital sign monitors based on auditory cues, in the context of multitasking in the operating room. This study aims to evaluate the ability of different anesthesia providers to estimate heart rate and oxygen saturation in a simulation setting.
Sixty anesthesia providers (residents, nurse anesthetics, and anesthesiologists) were studied. Four scenarios were arranged in a simulation context. Two baseline scenarios with and without waveform visual aid, and two scenarios with variation of heart rate and/or oxygen saturation were used to assess the accuracy of the estimation made by the participants.
When the accurate threshold for the heart rate was set at less than 5 beats per minute, the providers only had a correct estimation at two baseline settings with visual aids (=0.22 and 0.2237). Anesthesia providers tend to underestimate the heart rate when it increases. Providers failed to accurately estimate oxygen saturation with or without visual aid (=0.0276 and 0.0105, respectively). Change in recording settings significantly affected the accuracy of heart rate estimation ( < 0.0001), and different experience levels affected the estimation accuracy (=0.041).
The ability of anesthesia providers with different levels of experience to assess baseline and variations of heart rate and oxygen saturation is unsatisfactory, especially when oxygen desaturation and bradycardia coexist, and when the subject has less years of experience.
在手术室多任务处理的情况下，麻醉医生可能需要根据听觉线索解读生命体征监测仪的输出结果。本研究旨在评估不同麻醉医生在模拟环境中估计心率和血氧饱和度的能力。
对60名麻醉医生（住院医生、麻醉护士和麻醉科医生）进行了研究。在模拟环境中安排了四种场景。使用两种有波形视觉辅助和无波形视觉辅助的基线场景，以及两种心率和/或血氧饱和度有变化的场景，来评估参与者估计的准确性。
当将心率的准确阈值设定为每分钟低于5次心跳时，参与者仅在两种有视觉辅助的基线设置下有正确估计（分别为0.22和0.2237）。当心率增加时，麻醉医生往往会低估心率。无论有无视觉辅助，麻醉医生都未能准确估计血氧饱和度（分别为0.0276和0.0105）。记录设置的变化显著影响心率估计的准确性（<0.0001），不同的经验水平也影响估计准确性（=0.041）。
不同经验水平的麻醉医生评估心率和血氧饱和度的基线及变化的能力并不理想，尤其是当血氧饱和度降低和心动过缓同时存在时，以及当受试者经验年限较少时。
