Hearing Acuity of Anesthesiologists and Alarm Detection

Wallace, Mark; Ashman, Michael N.; Matjasko, M. Jane

doi:10.1097/00000542-199407000-00005

Cited by 51 publications

(14 citation statements)

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“…Fourth, the literature shows that the overwhelming majority of audible alarms in hospitals result in no action being taken. 77,[80][81][82] These alarms are, not surprisingly, a major source of irritation to patients and visitors. A ripe avenue for research is thus the effective use of audible alarms in hospitals, with the aim to preserve patient safety while reducing alarm noise.…”

Section: Discussionmentioning

confidence: 99%

“…Figures 1 and 2 show the results of our compilation of existing noise studies. [5][6][7][8][10][11][12][13][14][15][18][19][20][21][22][23]25,[31][32][33]35,[37][38][39]46,48,59,61,65,[76][77][78] In these and all other figures in this article, dB͑A͒ is referenced to 20 Pa and decibel averages refer to logarithmic or energy averages. The A-weighted L eq are graphed as a function of the year of publication of the study.…”

Section: Hospital Noise Levels Over the Yearsmentioning

confidence: 99%

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Noise levels in Johns Hopkins Hospital

Busch‐Vishniac

West²,

Barnhill³

et al. 2005

The Journal of the Acoustical Society of America

326

190

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This article presents the results of a noise survey at Johns Hopkins Hospital in Baltimore, MD. Results include equivalent sound pressure levels (L(eq)) as a function of location, frequency, and time of day. At all locations and all times of day, the L(eq) indicate that a serious problem exists. No location is in compliance with current World Health Organization Guidelines, and a review of objective data indicates that this is true of hospitals throughout the world. Average equivalent sound levels are in the 50-60 dB(A) range for 1 min, 1/2, and 24 h averaging time periods. The spectra are generally flat over the 63-2000 Hz octave bands, with higher sound levels at lower frequencies, and a gradual roll off above 2000 Hz. Many units exhibit little if any reduction of sound levels in the nighttime. Data gathered at various hospitals over the last 45 years indicate a trend of increasing noise levels during daytime and nighttime hours. The implications of these results are significant for patients, visitors, and hospital staff.

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Section: Discussionmentioning

confidence: 99%

Section: Hospital Noise Levels Over the Yearsmentioning

confidence: 99%

Noise levels in Johns Hopkins Hospital

Busch‐Vishniac

West²,

Barnhill³

et al. 2005

The Journal of the Acoustical Society of America

326

190

View full text Add to dashboard Cite

show abstract

“…The problem is worsened with increasing levels of background noise and may interfere with alarm detection. In a study of 188 anesthesiologists aged 28-80 yr, 66% had an abnormal audiogram, and 37% were unaware of their hearing problem 14. It is not clear why, but acuity was worse than in the general population up to age 54 yr, but it was similar at older ages.…”

Section: Physiological Changes Of Aging and The Practice Of Anesthesimentioning

confidence: 99%

“…Hearing impairment may begin to manifest at approximately age 40 yr 14. Common hearing problems in anesthesiologists include presbycusis (hearing impairment in the high frequency range), abnormal loudness perception, tinnitus, and difficulty with sound localization.…”

Section: Physiological Changes Of Aging and The Practice Of Anesthesimentioning

confidence: 99%

The aging anesthesiologist: a narrative review and suggested strategies

Baxter

Boet

Reid

et al. 2014

Can J Anesth/J Can Anesth

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PurposeTo address an aging anesthesia workforce, we review the relevant changes and implications associated with age in order to stimulate discussion at the individual, local, and national levels regarding appropriate changes in practice aimed at protecting patient safety.Principal findingsIn a 2013 survey of Canadian Anesthesiologists, 22% were aged 55-64 yr, 7% were aged 65-74 yr, and 3% were older than 74 yr. Clinical abilities decline with age, making older anesthesiologists more likely than their younger colleagues to be associated with adverse patient events. Anesthesiologists older than 65 yr in Ontario, Quebec, and British Columbia had 50% more cases involving litigation and almost twice the number of cases involving severe patient injury compared with anesthesiologists younger than 51 yr of age. In the absence of overt deterioration in skills, decisions about reducing activities and retirement are left largely to individuals despite their limited ability to self-assess competence. This state of affairs may contribute to the increased incidence of adverse events and poor patient outcomes.ConclusionsProvincial regulatory bodies have peer assessment programs to evaluate physicians at random, following a complaint, and at certain ages, but all have limitations. Simulation has been used widely for training and assessment in the aviation industry as well as in automobile driving exams. Simulation can assess crisis recognition and management, which is crucial in anesthesiology and not well assessed by other methods, and could assist elderly anesthesiologists during the pre-retirement phase of their careers. A standardized schedule for winding down would have advantages for physicians, their department, and their patients. A suggested schedule might include no further on-call duties for those aged 60 yr and older, no further high-acuity cases for those aged 65 yr and older, and retirement from operating room (OR) clinical practice (with possible continuation of non-OR clinical or other non-clinical activities, if desired) at age 70 yr. These timelines could be extended with satisfactory performance in annual simulation sessions involving assessment and practice in crisis management.

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“…Moreover, the possible effect of acoustic interference on teamwork should be tested with sonification delivered via earpiece versus speakers as well as for viability with hearing-impaired anesthesiologists (Wallace, Ashman, & Matjasko (1994).…”

Section: Evaluation and Further Needsmentioning

confidence: 99%