Volume 7, No. 1 • Spring 1992

FDA Checklist Seen Lacking

V. Rudolph Massey, Jr., M.D.

To the Editor

I would like to respond to the article in APSF Newsletter, Fall, 1991: ‘FDA Pre-anesthesia Checklist Being Evaluated, Revised” by David E. Lees, M. D. The FDA’s decision to streamline the Preoperative Anesthetic Checklist by categorizing the steps in a user friendly format is long overdue and should lead to increased operator compliance with the checkout routine.

The new initial step in the checklist, requiring a resuscitation bag and oxygen tank set-up prior to administering any anesthetic, is critically important. At the University of Mississippi Medical Center, an oxygen tank/resuscitation bag set-up near the head of the OR table has been mandatory for several years and is included in the pre-anesthetic checklist. It is one of the duties of the senior on-call resident to ensure that each OR still contains such a set-up prior to leaving the hospital post call.

The reference to Step 19 of the current Preanesthetic Check list provokes concern. Dr. Lees states-that “while checking to ensure adequate suction is a good work habit, it is not integral to the proper functioning of an anesthetic delivery system.’ Recognizing that it is not necessarily a component of the gas machine, I submit that there are few, if any, more important systems that should be present and functional prior to each anesthetic. Abandoning the suction checkout is a radical deviation from conventional wisdom.

I would encourage all anesthetic personnel to familiarize themselves with the new FDA guidelines as soon as these guidelines are available. I would also encourage the continued verification of suction prior to every anesthetic.

V. Rudolph Massey, Jr., M.D.

University of Mississippi Medical Center Jackson, MS