Stop suffocation of patients in theatres, advocates tell WHO

One device that measures the breathing of patients during operation not available in many Kenyan theatres.

In Summary

•The call to the WHO was made by Smile Train – an NGO which sponsors cleft lip corrections in Kenya and Lifebox, a non-profit that champions safer surgery.

•Without an oxygen supply, maybe due to a misplaced breathing tube, a patient can suffer brain damage or death within minutes.

Surgeons at a hospital in Kenya.
Surgeons at a hospital in Kenya.
Image: FILE

Two NGOs have petitioned the World Health Organization to list a device that measures if a patient is breathing properly during surgery, as a must-have in theatres.

Although capnography monitor devices significantly lower deaths on the operating table, they are not available in many Kenyan theatres.

The call to WHO was made by Smile Train, an NGO which sponsors cleft lip corrections in Kenya and Lifebox, an organisation that champions safer surgery.

The announcement was made during the 18th World Congress of Anaesthesiologists taking place in Singapore, which ended on Thursday.

The two blamed the absence of capnography monitors in most hospitals on its high cost and the scarcity of devices adapted to specific local needs.

A capnographs measures amount of carbon dioxide a patient breathes out during anaesthesia.

This can help detect problems along the airway taken by the carbon dioxide. For example, if the patient stops breathing, carbon dioxide will not be able to get out. This will trigger an alarm that alerts medical staff to the problem.

Without an oxygen supply, maybe due to a misplaced breathing tube, a patient can suffer brain damage or death within minutes.

“Working without capnography has been deeply concerning. It's like navigating a dark path without a flashlight; you know the dangers are there, but you're unable to see them until it is potentially too late,” said Dr Elizabeth Igaga, director of programmes safety at Smile Train.

This tool has been available in operating rooms in high-income countries for more than three decades. Its introduction in the United States in 1991 led to a dramatic decline in anesthesia-related complications and deaths.

Yet the devices remain largely unavailable across most low-resource-setting operating rooms.

“The absence of such a critical tool not only increases the risk to our patients but places an enormous amount of pressure on healthcare providers to anticipate, identify and manage complications without delay,” Igaga said.

Smile Train also donated 350 capnographs valued at over $300,000 to their partner hospitals in Benin, Ethiopia, Philippines and Uganda.

“Through our partnership with Lifebox, we have seen firsthand the lifesaving impact of capnography in surgical settings,” said Susannah Schaefer, president and CEO of Smile Train.

“We believe the inclusion of a capnograph by professional societies and national health authorities as an essential anaesthesia monitoring equipment in operating rooms will catalyse its adoption worldwide, ultimately saving countless lives.”

The two organisations also launched their Smile Train-Lifebox Capnograph, which they said is high-quality, user-friendly and affordable with long battery life suited for use in low-resource settings.

“Capnography shouldn’t be a privilege, it should be standard for surgical patient safety everywhere and it is needed now,” said Lifebox global CEO Kris Torgeson.

“Inclusion, for example, in operating room checklists as an essential piece of equipment would represent a monumental step in making surgery safer for every patient, regardless of where they live.”

Working with the World Federation of Anesthesiologists, the Global Capnography Project and other leaders in global anaesthesia, they also announced a comprehensive capnography training package for anaesthesia providers.

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