An evaluation of anesthesiologists' present checkout methods and the validity of the FDA checklist

The United States Food and Drug Administration (FDA) published the Anesthesia Apparatus Checkout Recommendations (checklist) in order to improve the methods anesthesiologists use to check out anesthesia equipment. Whereas no published study of current checkout methods had been performed since the introduction of the FDA checklist, we compared anesthesiologists' current anesthesia equipment pre-use checkout methods with anesthesiologists' use of the FDA checklist. One hundred and eighty-eight anesthesiologists were tested to compare the number of prearranged anesthesia machine faults that could be detected with 1) their own checkout methods and 2) the FDA checklist. The average number of machine faults detected with the individual anesthesiologists' checkout methods was 1.03/4 (25.8%) and with the FDA checklist was 1.20/4 (29.9%). For only one fault, malfunction of the oxygen/nitrous oxide ratio protection system, was there a statistically significant improvement (P less than 0.01) with the use of the FDA checklist. Anesthesiologists in residency training detected more faults (average 2.46/8, 30.8%) than did anesthesiologists who primarily practiced direct patient care (1.98/8, 23.9%) (P less than 0.01). Our data indicate that the mere introduction of the FDA checklist did not improve the ability of anesthesiologists to detect anesthesia machine faults.