Introduction Emergency caesarean sections are challenging life-threatening scenarios that involve multidisciplinary teams to ensure favorable outcomes. Most operation theatres (OT), especially in developing countries, tend to be shared with multiple surgical departments. Emergency caesarean section in such setups require preparation of the theatre with drugs and extra equipment in a short period of time, The goals of resuscitation in obstetric emergencies remain like any other medical emergencies with the distinction of focussing on the resuscitation and safety or ensuring minimum adversities to two lives. Stress, time constraints and human errors in a high-risk scenario are liable to lead to oversights and missed “critical” steps in ensuring “safe” pre-anaesthesia setup. The present study aimed to determine the efficacy of a validated anaesthesia safety checklist in reducing missed critical steps in pre-anaesthesia setup in simulated settings. Methods This prospective observational study was conducted in the Department of Anaesthesiology of a tertiary care center after obtaining approval from the Institutional Ethics Committee, and the study was registered with CTRI (057174). A curated anaesthesia safety checklist on pre-anaesthesia setup for class 1 emergency caesarean section was designed and validated by senior anaesthetists. The checklist was categorized into mandatory and desirable presence in the operating theatre. 25 anaesthesia residents selected at random in simulated settings and after obtaining informed consent from them, were asked to prepare the OT for an emergency caesarean section with and without the checklist. The incidence of missed steps was also assessed. The chi-squared test was used to assess statistical significance. Results Use of checklist showed significant improvements in the compliance to “mandatory” aspects of OT preparedness in technical aspects as well as presence of a critical drugs. “Desirable” attributes also showed significant improvements in the compliance. Conclusions The use of validated checklists as guides in simulated learning scenarios reduces the incidence of missing critical aspects of OT preparedness for emergency caesarean sections.
Kini et al. (Wed,) studied this question.