Vital Times 2021 - 60

ENGINEERING AND TECHNOLOGY
Exploring Ongoing Challenges
in Anesthesia Technology:
A Proposed " To-Do " List
D. John Doyle, MD, PhD, DPhil
T
he year 2022 marks 50 years since I received
my undergraduate physics degree and 40 years
since my graduation from medical school and
entry into anesthesiology training. Over these decades,
I have personally witnessed a great many technical
innovations that have contributed enormously to
improved perioperative patient safety. Hopefully, we will
see further innovations that will also improve anesthesia
delivery (Table 1). Such technological developments in
patient monitoring have had genuine salutary effects
on anesthesia safety and patient well-being, and this
important fact is reflected in drops in medical liability
insurance costs as new patient monitoring methods
came into practice over time. This has been particularly
true for pulse oximetry; in the " scale of honor " for patient
monitoring equipment, the pulse oximeter ranks near
the top, serving an inexpensive yet particularly useful
tool to improve situational awareness and promote
patient safety.
Still, all this marvelous technology gives the
anesthesiology world some things to be concerned
with. The cognitive load associated with " keeping all
gadgets running smoothly " is higher than in the distant
past when an eye on the chest and a finger on the pulse
constituted the two main modalities available by early
anesthesia pioneers. Not only do we now worry about
whether our monitoring and drug delivery equipment are
working okay and have been programmed correctly, but
care must also be taken when troubleshooting a piece
of hardware that one's attention is not drawn away from
the patient for too long.
In the perioperative world, many individuals find
themselves frustrated that there are still a great
many practical problems related to operating room
(OR) technology that remain to be addressed. In
many cases the solution to these problems lies not in
technical advances in fields such as AI, but simply in
better design and planning on the part of equipment
manufacturers and operating room architects. Example
problems include:
* Procedure rooms and ORs too small to support the
equipment used for modern endoscopy or similar
procedures, resulting in poor workspace layouts that
impair access to the patient or to needed equipment
* Insufficient electrical outlets in which to plug in
monitors, infusion pumps, video laryngoscopes,
ultrasound machines, endoscopes and other
mission-critical items
* Electrical outlets with spacing such that plugging in
a single " wall wart " type power supply brick prevents
access to all neighboring outlets
* Electrical equipment such as OR tables with
electrical cords too short to be plugged into local
wall outlets without producing a tripping hazard.
60 | CSA Vital Times

Vital Times 2021

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