Tuesday, April 22, 2014

Texting while "driving" in the OR

We all know we shouldn't text while driving, right? Because if you are going 30 miles per hour, your car has gone 44 feet for every second you are looking down at your iPhone. Bad things can happen even at that speed.  At 60mph, you go 88 feet per second.  Imagine how much damage you can do in that situation.  But remember the guy who said, "I only text on the highway"?

Well, now comes a new set of "drivers," doctors who text or otherwise use their electronic message devices while in the operating room. They are equally irresponsible.  Check out this article by Rebecca Buckwalter-Poza on Pacific*Standard. Excerpts:

In one ongoing malpractice case in Texas over the death of a 61-year-old woman following a low-risk cardiac procedure, attorneys for her family discovered that the anesthesiologist charged with administering anesthesia and monitoring the patient’s vital signs had been on his iPad throughout the operation. In his deposition, the surgeon testified that the anesthesiologist didn’t even notice the patient’s dangerously low blood-oxygen levels until “15 or 20 minutes” after she “turned blue.”

The anesthesiologist admitted to texting, accessing websites, and reading ebooks during procedures. He claimed, though, that “even when I’m doing so, I’m always listening to the pulse ox, always checking the blood pressure, always—you know, at least every five minutes.” It seemed lost on him that five minutes is an eternity in medicine: The brain begins to die after just a few minutes without oxygen.

While throughout the 1980s, most programs banned residents from so much as studying in operating rooms or on the ward, doctors now routinely do far more distracting things in these same settings, with no possible medical justification—from tweeting to texting to posting on Facebook.  

The term “distracted doctoring” doesn’t seem adequate to describe the phenomenon of health care providers who habitually use electronic devices for non-medical purposes during appointments and procedures. These doctors, nurses, and technicians aren’t momentarily distracted: They’re deciding to interact with Facebook friends or Twitter followers instead of the patient in front of them.

Perhaps hospitals should do what our local transit system does:  They prohibit even possession of cell phones by transit drivers while in buses and rapid transit vehicles.  Because if you have it, you will use it.


Susannah said...

Maybe we should pay anesthesiologists less than minimum wage, if their job is obviously so unimportant they don't have to do it.... Well of course not, but doesn't this kind of disengagement suggest the same? Bad enough to think that healthcare professionals are loath to remember to wash their hands, but this!

Doug, Patricia, Beverly said...

From Facebook:

Doug Hall: "No non-emergent cell phone use or non-clinical electronic devices allowed in the O.R." and back up the policy with 24/7 video coverage of O.R.'s. Easy breezy.

Patricia L. Hale: Banning technology needed to handle emergency calls, faster access to patient information and other medical needs is not the answer in my opinion...nor is banishing use of useful things because outliers misuse them... Teaching proper behavior and directly monitoring behavior is the answer...physicians and nurses should have reported and intervened on this way before a bad outcome! We work as patient care teams and we need to act like it!!!!!

Beverly Heywood Rogers: As Patricia says......in the old days when a surgeon's beeper went off the circulator would answer it to see if there was an emergency. I don't see why the same couldn't pertain for cell phones to screen for emergencies or access needed information. As for anesthesia, I know it's hours of boredom punctuated by moments of terror, but surfing the web? Just, no.

Janice, Mohammed, Bart, Isam said...

From Facebook:

Janice Lynch Schuster: I know that whenever I see a call coming in from my 12 yo's school, I jump to answer (because he has a health condition). But I always have a back up, for the rare times when I just cannot be available. I don't understand, really, what is so essential and imperative, that we have all become tethered to devices. Myself included.

Mohammad Kashif Sheikh: It's astounding to me that isn't already regulated. Seems like common sense.

Bart Windrum Since when has common sense pervaded the delivery of hospitalized medicine? (just a lay person talking…)

Isam Osman: Sorry Paul. Let me finish this AAA and then I'll get back to you. :)

Barry Carol said...

I wonder how these doctors would feel if they were the patient and their OR doc behaved this way. Maybe there should be unobtrusive surveillance video in all operating rooms to dissuade doctors from inappropriate use of electronic equipment as well as to provide a record of what happened when something goes wrong.

Thomas Pane said...

I am on the other side of the curtain so I can't speak for my anesthesia colleagues. I wonder if the monitor alarms were turned down or off. Normally when the O2 sat drops its obvious to all in the room from the sound. 15-20 min is a long time not to notice.

Matt Katz, MD said...

Thanks for writing the post, Paul. I wrote some similar concerns about the latest fad, Google Glass. There are published data suggesting that distracted doctoring is a real potential health risk. If you or any readers are interested I can give you citations.