ORIGINAL RESEARCH Impact of medical training and clinical experience on the assessment of oxygenation and hypoxaemia after general anaesthesia: an observational study Hansjo¨rg Aust • Peter Kranke • Leopold H. J. Eberhart • Arash Afshari • Frank Weber • Melanie Brieskorn • Julian Heine • Christian Arndt • Dirk Ru¨sch Received: 19 March 2014 / Accepted: 16 September 2014 Ó Springer Science+Business Media New York 2014 Abstract In Germany it is common practice to use pulse oximetry and supplementary oxygen only on request in patients breathing spontaneously transferred to the post- anaesthesia care unit (PACU) following surgery under general anaesthesia. The main aim was to study the influ- ence of medical training and clinical experience on assessing SpO 2 and detecting hypoxaemia in these patients. The second aim was to do a preliminary assessment whe- ther this practice can be found in countries other than Germany. Anaesthetists, nurses and medical students esti- mated SpO 2 in patients breathing room air at the end of transfer to the PACU following surgery (including all major surgical fields) under general anaesthesia. Estimated SpO 2 was compared to SpO 2 measured by pulse oximetry. A survey was carried out among European anaesthesists concerning the use of pulse oximetry and supplementary oxygen during patient transfer to the PACU. Hypoxaemia (SpO 2 \ 90 %) occurred in 154 (13.5 %) out of 1,138 patients. Anaesthetists, nurses, and medical students iden- tified only 25, 23, and 21 patients of those as being hyp- oxaemic, respectively. Clinical experience did not improve detection of hypoxaemia both in anaesthetists (p = 0.63) and nurses (p = 0.18). Use of pulse oximetry and supple- mental oxygen during patient transfer to the PACU in European countries differs to a large extent. It seems to be applied only on request in many hospitals. Considering the uncertainty about deleterious effects of transient, short lasting hypoxaemia routine use of pulse oximetry is advocated for patient transfer to the PACU. Keywords Patient safety Á Monitoring Á Pulse oximetry Á Oxygen Á Post-anaesthesia complications Abbreviations AAGBI Association of Anaesthetists of Great Britain and Ireland ASA ASA physical status classification system (based on ASA = American Society of Anesthesiologists) AZ ‘‘Aktenzeichen’’ (file-number) BMI Body mass index CI Confidence interval ESA European Society of Anaesthesiology FiO 2 Inspired oxygen fraction FeO 2 Expired oxygen fraction ICU Intermediate care unit MH Major hospital N 2 O Nitrous oxide Electronic supplementary material The online version of this article (doi:10.1007/s10877-014-9620-4) contains supplementary material, which is available to authorized users. H. Aust (&) Á L. H. J. Eberhart Á M. Brieskorn Á J. Heine Á C. Arndt Á D. Ru¨sch Department of Anaesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstrasse, 35033 Marburg, Germany e-mail: aust@staff.uni-marburg.de P. Kranke Department of Anaesthesia and Critical Care, University Hospitals of Wu¨rzburg, Oberdu¨rrbacher Str. 6, 97080 Wu¨rzburg, Germany A. Afshari Department of Anaesthesia, Juliane Marie Centre, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark F. Weber Department of Anaesthesia, Erasmus University Medical Center - Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, Netherlands 123 J Clin Monit Comput DOI 10.1007/s10877-014-9620-4