General Anaesthesia Checklist
Checklists are being developed in many areas of clinical practice with the aim of reducing human error in stressful situations by optimising preparation and structured management. Using checklists has been shown to improve patient safety and outcomes.
Management of an obstetric general anaesthetic, with the attendant risks of failed intubation, hypoxaemia and aspiration, is increasingly a significant source of anxiety as trainees perform fewer obstetric general anaesthetics; some trainees may not have performed an obstetric general anaesthetic on their own before doing solo on-call. This goes in tandem with a time-pressured environment during a category 1 caesarean section.
The NAP 4 study recommended that anaesthetists use a simple checklist based around preparation of the patient, equipment and drugs. Once established, use of a checklist can be performed without increasing the time to delivery and has been found to improve team working and reduce anxiety in anaesthetists.
The poster presentations and checklists below, developed in the UK, are designed for use by the anaesthetist and anaesthetic assistant in addition to the WHO checklist:
- James B, Bryant H, Swales H and Al-Rawi S. Obstetric general anaesthetic safety checklist: guideline development through team simulation. International Journal of Obstetric Anesthesia 2015; 24: S24. (presented at OAA Annual Meeting, Torquay 2015). Poster & Checklist
- Thomas A et al. Obstetric failed intubation case series: avoiding the chaos of an emergency caesarean section under general anaesthesia - are you H.A.P.P.E? International Journal of Obstetric Anesthesia 2014; 23: S21. (presented at OAA Annual Meeting, Dublin 2014. Poster & Checklist
- Wittenberg MD, Vaughan DJA, Lucas DN. A novel airway checklist for obstetric general anaesthesia. International Journal of Obstetric Anesthesia 2013; 22: 264-5. Checklist