Do you know what your O.R. team is up to while you’re lying there out cold during surgery? The New York Times has taken a revealing peek at the impact of electronic devices like smartphones on modern medical care – and it’s not a pretty picture.
The troubling issue is that your doctors, nurses and techs can be focused on the screen and not the patient, even during moments of critical care. This includes the neurosurgeon making personal calls during an operation, a nurse checking airfares in the O.R., and a frightening poll showing that half of technicians running bypass machines during open heart surgery had admitted texting while working on a cardiac procedure
Dr. Peter Papadakos is an anesthesiologist and director of critical care at the University of Rochester Medical Center in upstate New York. He recently published an article on these “electronic distractions” in the journal Anesthesiology News.
“My gut feeling is lives are in danger. We’re not educating people about the problem, and it’s getting worse.”
The Times article cites the medical malpractice case involving a Denver patient who was left partly paralyzed after surgery. The neurosurgeon was distracted during the operation, using a wireless headset to make personal calls on his cellphone. At least 10 of them were to family and business associates, according to phone records introduced in the lawsuit,which was settled out of court by the neurosurgeon.
Dr. Stephen Luczycki is an anesthesiologist and medical director in surgical intensive care at Yale-New Haven Hospital. He told The Times that when he was in medical training, he was admonished to not even study a textbook in surgery, so he could “focus on the rhythm and subtleties of the procedures.”
But in his current O.R. experience, he says he has “seen it all”:
“Amazon, G-mail, I’ve seen all sorts of shopping, I’ve seen eBay. You name it, I’ve seen it.”
Research on the troubling subject of electronic distraction among health care providers is beginning to emerge, according to Matt Richtel’s article in the Times.
For example, Dr. Trevor Smith’s peer-reviewed survey* of 439 medical staff was published this year in Perfusion, a medical journal about cardio-pulmonary bypass surgery. Dr. Smith’s team found that 55% of staff who monitor heart bypass machines acknowledged to researchers that they had talked on cellphones during heart surgery. Half said they had texted while in surgery.
As a heart patient, here’s where I found the results of this study to be downright creepy. The perfusionists studied reported that, while in the middle of cardio-pulmonary bypass surgery, they had:
- accessed e-mail (21%)
- used the internet (15.1%)
- checked/posted on social networking sites (3.1%)
While all this phoning, surfing and Tweeting are going on in the O.R., safety concerns were expressed by 78.3% of respondents who believe that cell phones can introduce a potentially significant safety risk to patients. Speaking on a cell phone and text messaging during CPB were regarded as “always an unsafe practice” by 42.3% and 51.7% of this study’s respondents, respectively.
Let’s take another hard look at these findings. Are Dr. Smith et al saying that half of medical personnel actually believe that phoning or texting or updating their Facebook status are NOT unsafe, inappropriate distractions while they’re in the middle of open heart surgery? Have these people taken multi-tasking to a new and deranged level of acceptance?
Dr. Smith’s study also found that personal distraction by cell phone use that negatively affected performance was admitted by 7.3%, whereas witnessing another perfusionist distracted with phone/text during coronary-pulmonary bypass surgery was acknowledged by 33.7% of respondents.
This study concludes:
“The majority of perfusionists believe cell phones raise significant safety issues while operating the heart-lung machine. However, the majority also have used a cell phone while performing this activity.
“There are clear generational differences in opinions on the role and/or appropriateness of cell phones during bypass surgery. There is a need to further study this issue and, perhaps, to establish consensus on the use of various communication modes within the perfusion community.”
There is “a need for further study”? How much more “study” might be required before all operating rooms everywhere ban the use of inappropriate distractions like cell phones, Internet browsing and social media updating during coronary bypass surgery?
Call me crazy, but I’d like to believe that the medical staff in the O.R. during my next cardiac event are paying attention to me and not to those irresistibly cute kitty videos on YouTube.
The study’s authors concluded:
“Such distractions have the potential to be disastrous.”
UPDATE June 9, 2014: A recent KevinMD column about live-broadcasting surgery called “Google Glass Has a Long Way To Go in the O.R.” reports on surgery performed in London while the surgeon wears Google Glass to film the procedure. The list of distractions is telling. For example:
- The surgeon talked about how many people in different countries were watching.
- He said that a number of text messages were coming up on his Google Glass screen.
- At 21 minutes into the case, he stopped for a 5-minute interview with a TV crew.
- He chatted with a colleague who came into the room.
- He asked questions of the audience and answered them himself.
- Several times, he asked his technical crew how things were going.
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* Smith T, Darling, E, Searles B. Perfusion. 2011 Sep;26(5):375-80. Epub 2011 May 18. 2010 Survey on cell phone use while performing cardiopulmonary bypass.