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Critical phase distractions in anaesthesia and the sterile cockpit concept
Author(s) -
Broom M. A.,
Capek A. L.,
Carachi P.,
Akeroyd M. A.,
Hilditch G.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06623.x
Subject(s) - distraction , cockpit , takeoff , medicine , anesthesia , general anaesthesia , aeronautics , psychology , automotive engineering , neuroscience , engineering
Summary In aviation, the sterile cockpit rule prohibits non‐essential activities during critical phases of flight, takeoff and landing, phases analogous to induction of, and emergence from, anaesthesia. We studied distraction during 30 anaesthetic inductions, maintenances and emergences. Mean (SD) noise during emergence (58.3 (6.2) dB) was higher than during induction (46.4 (4.3) dB) and maintenance (52 (4.5) dB; p < 0.001). Sudden loud noises, greater than 70 dB, occurred more frequently at emergence (occurring 34 times) than at induction (occurring nine times) or maintenance (occurring 13 times). The median (IQR [range]) of staff entrances or exits were 0 (0–2 [0–7]), 6 (3–10 [1–18]) and 10 (5–12 [1–20]) for induction, maintenance and emergence, respectively (p < 0.001). Conversations unrelated to the procedure occurred in 28/30 (93%) emergences. These data demonstrate increased distraction during emergence compared with other phases of anaesthesia. Recognising and minimising distraction should improve patient safety. Applying aviation’s sterile cockpit rule may be a useful addition to our clinical practice.