Incidence and impact of distracting events during induction of general anaesthesia for urgent surgical cases

Abstract

During the induction phase of general anaesthesia, distracting events are frequent and affect significantly the task at hand. Future research should design and implement preventive strategies to minimize the occurrence of unnecessary distracting events during this critical phase of anaesthesia when calm and vigilance should prevail.

Leadership and teamwork in anesthesia – Making use of human factors to improve clinical performance

“…Indeed, interruptions and distractions have been identified as a frequent source of disturbance with mostly negative influence on patient management. 37,38 Postoperative issues of patients transferred to the postanesthesia care unit or to the ward sometimes may cause the physician anesthesiologist to leave the OR, and to delegate clinical tasks to anesthesia nurses, residents or to anesthesiologist assistants. Work flow in anesthesia is therefore often fragmented, team composition variable, and leadership is mostly occurring in short-lived ad-hoc teams.…”

“…Furthermore, evidence inferred from other clinical fields and from other industries should be validated for the setting of anesthesia and perioperative care. Particular problems for future research include (a) the impact of production pressure 4 on teamwork and team performance in short-lived teams, (b) the effectiveness of leadership practices to prevent or compensate negative effects such as substandard workarounds or violations, 64 (c) how distractions and interruptions resulting from the dynamic perioperative work setting interact with team effectiveness and patient outcomes, (d) how team leaders and members can best address these distractions, 37,65 and (e) which handover techniques are most effective to improve patient outcomes. 66 …”

Con: Perioperative Transthoracic Echocardiography Should Not Be an Integral Part of the Anesthesiology Residency Core Curriculum

“…The clinical management decisions that may be based on the echocardiographic images obtained and interpreted by an inexperienced trainee may be a distractor from adequate patient care, as shown during both anesthesia induction and resuscitation efforts. 32,33 There also exists the concern that clinically relevant findings might be missed during these limited studies.…”

Who is distracting whom?

“…In their editorial, Martin and Grocott state "there is no discussion about, or reference to, the possible risks of hyperoxaemia in this document, and it is unclear whether such risks have been taken into account in its development". However, the guideline explicitly discusses the possible risks of hyperoxaemia and its as yet unproven clinical significance, and cites publications that were taken into consideration [3,4].…”

“…In conjuction with their [2] and other groups' [3,4] previous work, it is becoming increasingly, if unsurprisingly, apparent that operating theatres are noisy, distracting places in which to work. This may have both negative and positive effects [5][6][7].…”