Study reveals how Lifebox pulse oximeters lead to patient safety improvement

Press Release:

A new report published today in the journal Anaesthesia reveals the positive impact of the donation of Lifebox pulse oximeters and training to patient safety in Malawi. The year-long study investigated the effect of the charitable donation of 83 pulse oximeters, along with intense training for anaesthesia providers in their use, and management of any oxygenation failures detected. The study demonstrated how the sustainable introduction of this essential monitoring equipment contributed to improvements in patient safety, including a 36 percent reduction in the number of patients who experienced a lack of oxygen in their bloodstream during and after surgery.

Malawi is in sub-Saharan Africa and has a population of 16.4 million, but only 109 anaesthesia providers. Unlike in the UK, 95 percent are not doctors, and a study 10 years ago showed that the mortality rate attributable to anaesthesia in Malawi was up to a 100 times higher than in higher-resource settings.

Pulse oximetry measures oxygen in the bloodstream, sounding a warning alarm as the levels drop. An international standard for safe anaesthesia, it is used universally in high resource countries as the most essential safety monitor in the operating theatre. However, due to cost, distribution problems and lack of environment-appropriate technology, only one third of hospitals in Malawi had a pulse oximeter in every operating theatre before the donation of Lifebox pulse oximeters. The fact that the large-scale distribution was accompanied by training in using the new equipment (a standard component of Lifebox 2 activities) was also thought to be key to the sustained success, in terms of the safety improvements demonstrated.

“We’re proud to partner with our colleagues in Malawi on a study that demonstrates what we know to be true: that anaesthesia providers given essential tools and training can significantly improve the safety of surgery for their patients,” said Kris Torgeson, Lifebox’s Global CEO. “Every surgical patient deserves safe care, wherever they are in the world. With a 36% reduction in dangerous episodes, oximeters in regular use, and provider knowledge levels improved and sustained, this study shows the measurable impact that Lifebox are having with simple, low-cost interventions.”

The Lifebox Foundation was formed in 2011 by leading medical professional organisations, including the Association of Anaesthetists of Great Britain and Ireland (AAGBI), and is chaired by surgeon and author Atul Gawande. Growing out of the WHO Surgical Safety Checklist, Lifebox works to improve the safety of surgery and anaesthesia in low- and middle-income countries ( Through donations and partnerships with healthcare networks, civil society and government Lifebox has facilitated the distribution of more than 15,000 pulse oximeters, alongside education, monitoring and evaluation, to 100 countries worldwide in the last six years.

Notes to Editors

The full report can be accessed online through the journal Anaesthesia on 25 April 2017 (02:00 GMT), using this url

For further information and interview opportunities please contact Stephanie Addington, Marketing and Communications Manager, AAGBI by telephone +44 (0) 20 7631 8854 or email Twitter @AAGBI3

About Anaesthesia journal

Anaesthesia is the official journal of the Association of Anaesthetists of Great Britain and Ireland and is international in scope and comprehensive in coverage. It publishes original, peer-reviewed articles on all aspects of general and regional anaesthesia, intensive care and pain therapy. Its Impact Factor for 2015 is 3.8 and it is 5th out of 31 (Anesthesiology) in the ISI Journal Citation Reports© Ranking.

About The Association of Anaesthetists of Great Britain and Ireland (AAGBI)

As the professional membership organisation for over 11,000 anaesthetists in the UK and Ireland, the AAGBI promotes patient care and safety, and advances anaesthesia through education, publications, research and international work, as well as the professional aspects of the specialty. The AAGBI is a founder organisation of The Lifebox Foundation. The AAGBI’s motto in somno securitas (safe in sleep) encapsulates the major focus of the AAGBI: safety in anaesthesia

About The Lifebox Foundation

Lifebox Foundation is a leading NGO committed to making surgery and anaesthesia safer on a global scale. Founded by renowned surgeon and author Atul Gawande, Lifebox provides essential, environment-appropriate equipment and training to hospitals in more than 100 countries worldwide. To find out more, visit or Twitter @SaferSurgery.

About The College of Anaesthetists of Ireland

The College of Anaesthetists of Ireland exists to promote high-quality practice in the fields of Anaesthesia, Intensive Care and Pain Medicine through its training, examinations and educational programmes. The College has been involved in training anaesthetic clinical officers and running an MMED programme for medical anaesthetists in Malawi for over 12 years. The College supported a group of anaesthetists to deliver Oximetry training there with equipment donated by Lifebox.