Circulation 84,122 • Volume 23, No. 2 • Summer 2008   Issue PDF

Reader Recommends Zero Tolerance

William Higgins, CRNA

To the Editor

First I would like to confer my support for the APSF. An open forum is the best way to discuss and solve safety issues.

Second, it is good to see the APSF fund safety research initiatives. One hopes, the $1.092 million recently divided among a number of proposals will make a difference.

I have to take umbrage with Dr. Asokumar Buvanendran’s proposal “Patients after Minor Surgery with MAC: Is It Safe to Drive?”

Is this research necessary, and does it pass a common sense test? Have we as a society minimized the attention we pay to driving safety well beyond what is reasonable? Would MADD (Mothers Against Drunk Driving) approve of this research?

National Highway Traffic Safety Administration statistics for 2006 show that 42,642 people were killed and 2,575,000 people were injured in motor vehicle accidents for the previous 1-year period. Over 17,000 of the deaths were alcohol related.

Blood alcohol content (BAC) research originally looked at BAC from .02% to 0.1% and found impairment was commonly seen at the .02% levels, but we have rather arbitrarily fixated on .08% as the “safe” BAC. Many other countries have set lower limits.

Cell phones, GPS screens, eating, even in-dash video screens are the norm. Drunk driving and speeding is rampant. I jog, cycle, and motorcycle and am commonly a victim of driver inattention and distraction. Now I might have to worry about a driving, hungry, sleep deprived colonoscopy patient calling ahead his take-out food order on his cell phone!

Dr. Buvanendran’s proposal contends if we can return to a baseline level of weaving, reaction times, and collisions on a driving simulator we can drive home. Would he also contend that we are able to return to work safely as well? Should your surgeon, anesthesia provider, and nursing staff go back to work after sedation or a glass of wine at lunch?

There should be NO double standard for driving performance and everything else. We as health care professionals should champion a zero tolerance of intoxicants while driving.

William Higgins, CRNA
Kaneohe, HI