[User behavior during functional testing of the ventilator: analysis of the use of the QUICKcheck and detection of misconnected ventilation tubes].

BACKGROUND AND RESEARCH QUESTION

While patient safety during general anesthesia has improved in recent years, incidents still occur in anesthesia, particularly in the area of airway management and ventilation. In addition to a mandatory daily system test before using a ventilator, a QUICK check is recommended by the German Society of Anesthesiology and Intensive Care Medicine (DGAI) before connecting a patient; however, misconnections of breathing tubes are still possible and not necessarily detected by the device self-test. The aim of the present study was to analyze user behavior at modern anesthesia workstations regarding the verification and functionality of the QUICK check.

MATERIAL AND METHODS

A monocentric prospective recording of user behavior in handling the QUICKcheck was carried out as part of a medical simulation training course as well as a prospective, multicenter, explorative, anonymous survey of anesthesiology staff in various German hospitals.

RESULTS

Out of 30 participating physicians 93.3% (n = 28) carried out a QUICK check immediately before connecting the simulation patient to the ventilator. Only 1 (96.6%) of the physicians did not recognize the incorrect connection of the ventilation tubes during their QUICK check. Of the participating physicians, 80% did not use the separate bag valve mask despite persistent ventilation problems on the ventilator. The online survey was answered by n = 187 participants, 64.7% of the participants stated that they always carry out the QUICK check, 31.5% sometimes and 3.7% never. The presence of a separate bag valve mask is always checked by 66.3% of respondents, by 29.8% sometimes and by 3.8% never. Of the physicians, 32% believed that the integrated self-test always recognizes a misconnection of the ventilation tubes.

CONCLUSION

The present study reveals a heterogeneous picture of the application and understanding of the QUICK check as recommended by the DGAI. The lack of understanding of a standardized implementation of the check can be seen as further evidence of the importance of interdisciplinary training with a focus on human factors, communication and cooperation as opposed to a mere procedural implementation of established tools.