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OBSTETRIC ANESTHESIA

Errors and Omissions in Anesthesia: A Pilot Study Using a Pilot’s Checklist

Flinders Clinical Skills and Simulation Unit, Flinders University Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Bedford Park, SA 5042, Australia

Address correspondence and reprint requests to Harry Owen, MD, FRCA, FANZCA, Flinders University Department of Anesthesia and Intensive Care, Flinders Medical Centre, Bedford Park, SA 5042, Australia. Address e-mail to harry.owen{at}flinders.edu.au.

There are recent concerns that anesthesiologists are becoming less skilled in providing general anesthesia for Cesarean delivery. We considered whether a verbal checklist would help in the preparation for this event. We created a list of items to be checked when preparing to administer general anesthesia for a Cesarean delivery using expert opinion. This list was loaded onto an electronic checklist system with voice prompts and tested on 20 anesthesiologists using a high-fidelity anesthesia simulator. Participants omitted to check a median of 13 (range, 7–23) of 40 items. Common omissions included not checking that the difficult intubation trolley was available and not optimizing the patient’s head position. Most (95%) participants felt that the checklist was useful and 80% would like to use it for practicing simulated scenarios; 60% preferred a written checklist and 40% preferred the verbal checklist. Important checks may be forgotten when preparing to give a general anesthetic for Cesarean delivery, and the use of a checklist could improve patient safety.

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