Anaesthetists' management of oxygen pipeline failure: room for improvement

Oxygen pipeline failure is a rare but potentially catastrophic event which can affect the care of patients throughout an entire hospital. Anaesthetists play a critical role in maintaining patient safety, and should be prepared to support an institution-wide emergency response if oxygen failure occurs. We tested the preparedness for this through observation of 20 specialist anaesthetists to a standardised simulator scenario of central oxygen supply failure. Responses were documented using multiple approaches to ensure accuracy. All anaesthetists demonstrated safe immediate patient care, but we observed a number of deviations from optimal management, including failure to conserve oxygen supplies and, following restoration of gas supplies, failure to test the composition of the gas supplied from the repaired pipelines. This has implications for patient care at both individual and hospital level. Our results indicate a gap in anaesthesia training which should be addressed, in conjunction with planning for effective hospital-wide responses to the event of critical resource failure.