Quantitative description of the workload associated with airway management procedures - 04/09/11
: Professor of Anesthesiology, Staff Physician, Alison G Vredenburgh, PhD a : Postdoctoral Fellow in Anesthesiology, Cynthia Mills Schumann, BS a : Research Assistant in Anesthesiology, Alex Macario, MD, MBA b : Assistant Professor of Anesthesia Health Research & Policy, Kevin J Williams, PhD f, Michael J Kalsher, PhD e, Brian Smith, MD b, d : Clinical Instructor in Anesthesia, Staff Physician, Phuong C Truong b, Ann Kim b : Research Assistant in AnesthesiologyAbstract |
Study Objectives: To measure the workload associated with specific airway management tasks.
Setting and Intervention: Written survey instrument.
Patients: 166 Stanford University and 75 University of California, San Diego, anesthesia providers.
Measurements and Main Results: Subjects were asked to use a seven-point Likert-type scale to rate the level of perceived workload associated with different airway management tasks with respect to the physical effort, mental effort, and psychological stress they require to perform in the typical clinical setting. The 126 subjects completing questionnaires (overall 52% response rate) consisted of 43% faculty, 26% residents, 23% community practitioners, and 8% certified registered nurse-anesthetists (CRNAs). Faculty physicians generally scored lower workload measures than residents, whereas community practitioners had the highest workload scores. Overall, workload ratings were lowest for laryngeal mask airway (LMA) insertion and highest for awake fiberoptic intubation. Airway procedures performed on sleeping patients received lower workload ratings than comparable procedures performed on awake patients. Direct visualization procedures received lower workload ratings than fiberoptically guided procedures.
Conclusions: These kinds of data may permit more objective consideration of the nonmonetary costs of technical anesthesia procedures. The potential clinical benefits of the use of more complex airway management techniques may be partially offset by the impact of increased workload on other clinical demands.
Le texte complet de cet article est disponible en PDF.Keywords : Airway management, anesthesia tasks, human factors, intubation, fiberoptic, larynx, laryngeal mask airway, laryngoscopy, stress, psychological, workload
Plan
 | Supported in part by the Anesthesia Patient Safety Foundation, Pittsburgh, PA, and the National Patient Safety Foundation, Chicago, IL. |
Vol 12 - N° 4
P. 273-282 - juin 2000 Retour au numéro
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