[User behavior during functional testing of the ventilator: analysis of the use of the QUICKcheck and detection of misconnected ventilation tubes].

Background and research question: While patient safety during general anesthesia has improved in recent years, incidents still occur in anesthesia, particularly in the area of airway management and ventilation. In addition to a mandatory daily system test before using a ventilator, a QUICK check is recommended by the German Society of Anesthesiology and Intensive Care Medicine (DGAI) before connecting a patient; however, misconnections of breathing tubes are still possible and not necessarily detected by the device self-test. The aim of the present study was to analyze user behavior at modern anesthesia workstations regarding the verification and functionality of the QUICK check.

Material and methods: A monocentric prospective recording of user behavior in handling the QUICKcheck was carried out as part of a medical simulation training course as well as a prospective, multicenter, explorative, anonymous survey of anesthesiology staff in various German hospitals.

Results: Out of 30 participating physicians 93.3% (n = 28) carried out a QUICK check immediately before connecting the simulation patient to the ventilator. Only 1 (96.6%) of the physicians did not recognize the incorrect connection of the ventilation tubes during their QUICK check. Of the participating physicians, 80% did not use the separate bag valve mask despite persistent ventilation problems on the ventilator. The online survey was answered by n = 187 participants, 64.7% of the participants stated that they always carry out the QUICK check, 31.5% sometimes and 3.7% never. The presence of a separate bag valve mask is always checked by 66.3% of respondents, by 29.8% sometimes and by 3.8% never. Of the physicians, 32% believed that the integrated self-test always recognizes a misconnection of the ventilation tubes.

Conclusion: The present study reveals a heterogeneous picture of the application and understanding of the QUICK check as recommended by the DGAI. The lack of understanding of a standardized implementation of the check can be seen as further evidence of the importance of interdisciplinary training with a focus on human factors, communication and cooperation as opposed to a mere procedural implementation of established tools.