ERRORS ON ANESTHETIC RECORD CHARTS AS A MEASURE OF ANESTHETIC PERFORMANCE DURING SIMULATED CRITICAL INCIDENTS

We have measured the performance of 10 trainee anaesthetists during a single simulated anaesthetic during which there was a complex critical incident. Errors in the recording on the anaesthetic charts of the '' patient's'' oxygen saturation, heart rate, systolic and diastolic arte rial pressures and end-tidal carbon dioxide concentrations were used a s a measure of mental workload and hence performance. The critical inc ident was designed to be stressful and contained, in sequence, episode s of hypotension, arrhythmia and bronchospasm. Chart recording errors increased markedly during the critical incident (P < 0.01) and decreas ed subsequently when the ''patient'' had stabilized. More than 22% of the values charted during the simulation were in error by more than 25 % of the real value, and errors in excess of 100% of the actual value were recorded. There was no evidence of a tendency to consistently und erestimate the magnitude of abnormal values. This method is appropriat e for assessing the performance of groups of anaesthetists during simu lated critical incidents. It also raises questions on the accuracy of anaesthetic record charts when recording critical incidents.