Anaesthesia
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Fatigue has been implicated in the occurrence of critical incidents. Using a driving simulator to assess vigilance, we investigated the effect of sleep disruption on the ability of anaesthetists to maintain vigilance after a night on-call. Following an undisturbed night of sleep, subjects demonstrated a significant improvement in their vigilance scores. ⋯ The timing of disturbance had a bearing on performance. Subjects' performance was worse if their sleep had been disturbed in the first third of the night. The effect of sleep disruption on vigilance has implications for patient safety during anaesthesia.
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In order to establish current practice with regard to the reuse of infusion equipment between patients receiving total intravenous anaesthesia (TIVA), a postal survey of 393 consultants was carried out. Additionally, consultants' awareness of relevant guidelines was assessed. Overall, 46% of consultants change all equipment between cases, 37% change one-way valves and 17% change distal lengths of the infusion tubing. ⋯ Disposal of all equipment between cases incurs a 26% greater cost when compared to changing one-way valves alone. Variation in practice between consultants creates the potential for system errors. Practice should be standardised and, to comply with the published guidelines, should involve disposal of all equipment between cases.