I would like to respond to the February 2015 Anesthesia Incident Reporting System case report about the detached arm board incident. I have seen this happen myself. An arm board that looks locked but isn’t, when leaned on or bumped, can easily fall off the bed, as shown in the report of this case.

There is a simple test to markedly reduce the chance of this happening. Having been a nurse and a CRNA in the past, prior to medical school and anesthesia residency, I have noticed that no one anymore teaches how to test to see if an arm board that looks locked securely in place actually is. After placing the arm board, simply lift up on the end of it. If the locking mechanism is truly locked, you will not be able to lift the end of the board. If it is not locked, the board will fall...

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