Volume 5, No. 1 • Spring 1990

Aviation Analogies Revisited: Removal of Distractions Urged

John G. Morrow, III, M.D.

To the Editor

An article and a letter in the APSF newsletter draw attention to the many parallel safety rules, regulations, and practices which exist between the anesthesia profession and the aviation industry. The inference is that the anesthesia profession, by emulating the well-proved safety practices of the aviation industry, can seek to improve its safety record to the enviably high level currently enjoyed by commercial aviation.

There remains an aviation mw regulation, that of excluding extraneous people from the cockpit and then dosing and locking the cockpit door to prevent disconcerting distractions during the critical times of take-off and landing, which the medical profession, in general, and the anesthesia profession, in particular, have faded to copy. To the contrary, the doors to operating suites, labor and delivery suites, radiology departments, special procedure rooms and emergency departments have been flung open to anyone and everyone at any time and for any reason in order to accommodate the new age of patient enlightenment.

At the same time, efforts are being undertaken to obtain the cooperation of the manufacturers of medical monitoring devices to standardize alarm sounds to prevent the distracting cacophony frequently heard in the anesthesia workplace. Prudence and logic dictate that efforts exerted toward reducing distractions in anesthetizing locations should be applied to all discoverable and correctable distractions.

The pilot who closes and locks the cockpit door should be sending a message to the entire medical profession. Those people not essential to the task at hand and who may serve as distractions to those who are have no place in critical places at critical times. In this regard, the aviation industry is a quantum leap ahead of anesthesiology. We, the medical profession as a whole and the specialty of anesthesiology, in particular, must heed the pilot’s warning and follow his example.

John G. Morrow, III, M.D. Macon, GA