Vigilance, Not Reading, Prevents “Tube-Tech” Idea

David K. Black, M.D.

To the Editor

In response to the Letter to the Editor (‘Is It OK to Read During OR Cases?’) from the Winter 1994-95 APSF Newsletter, my answer is an unqualified no! Unless I have missed the point, one of the guiding principles expressed on our society’s coat of anus is vigilance. Nowhere on our society’s coat of arms or in our training is there mention of distraction or inattention as a guiding principle.

I have made it my personal mission as an academic anesthesiologist to impress on our trainees the importance of vigilance, attention to detail, and attention to the surgical field while providing anesthesia. Yet, frequently I observe residents, CRNA’s, and fellow staff anesthesiologists reading in the operating room. just as frequently, I observe surgeons and operating room nurses bringing a situation to the attention of the anesthesia provider that should have been noticed had the anesthetist been vigilant.

Needless to say, this has potential impact on patient safety, and it also affects how we are viewed by our surgical colleagues.

As a medical specialty, we have made great strides in the field of perioperative management and the provision of safe and effective anesthetics. Too often, our expert medical judgement is challenged by our surgical colleagues, and there is often evidence in those interactions of a credibility gap. I submit that the common practice of reading in the operating room encourages the impression among our surgical colleagues that anesthesiologists are simply ‘tube techs” disinterested and inattentive. I do not encourage that impression by our surgical colleagues and I will not tolerate behavior that predisposes to it.

David K. Black, M.D.

Department of Anesthesiology

Naval Regional Medical Center, Oakland, CA