I-gel insertion by novices in manikins and patients.

The i-gel, a novel supraglottic airway, has been proposed for use during cardiopulmonary resuscitation. We evaluated the performance of this device in manikins and anaesthetised patients when used by novices: medical students, non-anaesthetist physicians and allied health professionals all unfamiliar with the i-gel. Fifty i-gels were placed in manikins. Eighty-eight percent (44/50) were placed on the first attempt with a median insertion time of 14 s (range 7-45). I-gels were placed in 40 healthy anaesthetised patients. Success on the first attempt was 82.5% (33/40) and on the second attempt 15% (6/40). After three attempts there were no failures. Median insertion time was 17.5 s (range 7-197). Median airway seal was 20 cmH(2)O (range 13-40). One case of regurgitation and partial aspiration occurred. Our results suggest the i-gel is rapidly inserted in both manikins and patients by novice users and compares favourably to other supraglottic airways available. Further work determining safety and efficacy during cardiopulmonary resuscitation is required.

High latent drug administration error rates associated with the introduction of the international colour coding syringe labelling system.

BACKGROUND AND OBJECTIVES: The potential for increased drug administration errors during the transition to the International Colour Coding syringe labelling system has been highlighted. The purpose of this study was to assess the potential effects before their introduction into our department. METHODS: Thirty-one anaesthetists, 19 with no previous practical experience of the new labelling system (Group 1), and 12 with previous experience (Group 2), volunteered to induce general anaesthesia for a standardized simulated patient in a designated theatre. They were presented with a scenario designed to suggest the need for a rapid sequence induction and provided with drug syringes labelled with the International Colour Coding system. All drug administrations were recorded. Active error was defined as the injection of the wrong drug. Latent error was defined as the selection of a syringe in error but stopping short of administering the drug. RESULTS: In Group 1 a total of 107 drug injections were recorded of which 1 (0.9%) was an active error and 16 (15%) involved latent errors. Eleven anaesthetists (58%) performed at least one latent error. Group 2 had an error rate of 3%, a 6.9 (1.3-26.7) fold reduction in the rate of error (P = 0.023). CONCLUSIONS: Although only one drug was given in active error, latent errors occurred in 15% of drug administrations. The only factor conferring protection against error was prior experience of the new labelling system. The period of transition to the International Colour Coding syringe labelling system represents a time of increased risk of drug administration error.

A comparison of two solid phase systems for antibody detection.

Two solid phase methods of antibody detection, Capture-R (CR) and Capture-R Ready-Screen (RS), were compared to determine their acceptability for use in prenatal antibody screening. Ninety-six serum samples, screened using a saline antiglobulin test, were coded and tested by CR and RS at two laboratory sites using a blinded study design. Thirty of the samples were free of antibody, and 66 samples contained antibody. Parallel testing was also performed in both laboratories on 648 prenatal samples. The sensitivity and specificity of CR, based on the 96 previously screened samples, was 95 percent and 90 percent, respectively, and the sensitivity and specificity of RS was 90 percent and 89 percent, respectively. Antibodies detected only by CR included anti-K(1), -Ch(2), -Jka(1), -Lea(1), -Fya(1), -Mca(1), and -e(1). Antibodies detected only by RS included anti-Jka(5) and -E(1). The sensitivity and specificity of CR for the 648 prenatal samples was 100 percent for each, while the sensitivity and specificity of RS was 97 percent and 100 percent, respectively. Both CR and RS are acceptable techniques for prenatal antibody screening.