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Unplanned incidents during comprehensive anesthesia simulation.

A DeAnda1, D M Gaba

  • 1Department of Anesthesia, Stanford University School of Medicine, Palo Alto, California.

Anesthesia and Analgesia
|July 1, 1990
PubMed
Summary
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Anesthesia residents experienced unplanned incidents, primarily due to human error and fixation errors, not equipment failure. Training should focus on recognizing and responding to these common anesthesia events.

Area of Science:

  • Anesthesiology
  • Medical Simulation
  • Patient Safety

Background:

  • Unplanned incidents occur during anesthesia training.
  • Understanding the causes of these incidents is crucial for improving patient safety.
  • Simulation environments provide a controlled setting to study these events.

Purpose of the Study:

  • To analyze and classify unplanned incidents during anesthesia residency training.
  • To identify the primary causes of these incidents, focusing on human error versus equipment failure.
  • To inform educational strategies for anesthesia residents.

Main Methods:

  • Recordings of first- and second-year residents in a simulation environment were analyzed.
  • A modified critical incident technique was used to document and classify incidents.

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  • Incidents were categorized as human errors, equipment failures, fixation errors, or unknown causes.

    • Main Results:

    • 132 unplanned incidents were documented across 19 simulations.
    • Human errors (65.9%) and fixation errors (20.5%) were the most frequent causes.
    • Equipment failures accounted for only 3% of incidents.
    • A significant difference in incidents was observed between resident groups.

    Conclusions:

    • Human error is the predominant cause of unplanned incidents in anesthesia training.
    • Fixation errors are a frequent and significant contributor to these incidents.
    • Anesthesia education should emphasize event recognition and response strategies alongside prevention.