Anesthesia equipment and their chain of survival

Objectives: Anesthesia is a technology driven specialty, technological advancement in anesthesia and monitoring equipment has made sophisticated surgery possible. Safe anesthesia is possible when machines are in good condition. The chain of survival as used by the International Liaison Committee on Resuscitation refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest. A similar chain can be applicable to anesthetic equipment for optimal patient care. Early acquisition of appropriate equipment, appropriate training of end users, prompt preventive maintenance, timely repair, and replacement at the end of the equipment lifespan. In 2002, the Federal Government of Nigeria (FGN) commissioned a project to refurbish eight teaching hospitals which was later upgraded to 14. This paper assessed the functional status of 10 frequently used equipment in anesthesia and intensive care units among the beneficiaries. Material and Methods: A structured questionnaire was sent to heads of anesthesia departments in the 14 beneficiary hospitals of the FGN/VAMED intervention. They reported on the status of 10 equipment commonly used by anesthetists in the operating rooms and intensive care units. Results: All hospitals had the equipment installed in the past 7–14 years with end user training on all the equipment, biomedical engineers were available in the immediate post-installation period. There has been no routine scheduled preventive maintenance of the equipment. Faulty equipment are being used in all the hospitals, 54.6% of the installed equipment are spoilt and no longer in use. The weakest link in the equipment chain of survival is the absence of preventive maintenance. Conclusion: Routine scheduled preventive maintenance and the constant availability of trained and skillful biomedical engineers will no doubt increase the lifespan of anesthetic equipment.