Uzun Davut D, Schäfer Johannes, Klemm Sascha, Lichtenstern Christoph, Weigand Markus A, Neuhaus Christopher
Medizinische Fakultät Heidelberg, Klinik für Anästhesiologie, Universität Heidelberg, Im Neuenheimer Feld 420, Heidelberg, Deutschland.
Anaesthesiologie. 2025 Feb;74(2):72-80. doi: 10.1007/s00101-024-01496-0. Epub 2025 Jan 30.
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.
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.
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.
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.
尽管近年来全身麻醉期间的患者安全有所改善，但麻醉事件仍有发生，尤其是在气道管理和通气领域。除了在使用呼吸机前进行强制性的每日系统测试外，德国麻醉与重症医学学会（DGAI）建议在连接患者前进行快速检查；然而，呼吸管误连接仍有可能发生，且设备自检不一定能检测出来。本研究的目的是分析现代麻醉工作站中用户在快速检查的验证和功能方面的行为。
作为医学模拟培训课程的一部分，对处理快速检查的用户行为进行了单中心前瞻性记录，并对德国各医院的麻醉科工作人员进行了一项前瞻性、多中心、探索性、匿名调查。
在30名参与研究的医生中，93.3%（n = 28）在将模拟患者连接到呼吸机之前立即进行了快速检查。只有1名医生（96.6%）在快速检查期间未识别出通气管道的错误连接。在参与研究的医生中，尽管呼吸机持续存在通气问题，但80%的医生未使用单独的袋阀面罩。在线调查有n = 187名参与者回复，64.7%的参与者表示他们总是进行快速检查，31.5%有时进行，3.7%从不进行。66.3%的受访者总是检查是否有单独的袋阀面罩，29.8%有时检查，3.8%从不检查。在医生中，32%认为集成自检总能识别通气管道的误连接。
本研究揭示了DGAI推荐的快速检查在应用和理解方面存在差异。对检查标准化实施的理解不足可被视为进一步证明了以人为因素、沟通与合作为重点的跨学科培训的重要性，而不仅仅是对既定工具进行程序性实施。
