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March 19, 2008

BehindTheMedspeak: What's on your anesthesiologist's monitor — Your vital signs... or YouTube?

It could well be YouTube or its ilk up on the screen rather than your EKG and end-tidal CO2.

A study presented at the 2008 meeting of the Society for Technology in Anesthesia (STA) in San Francisco "... found that slightly more than half of Web visits recorded on 15 OR computers at the facility [Children's Hospital of Pennsylvania (CHOP)] were made with no clear connection to work — links like Amazon.com, Travelocity.com and eBay.com," wrote Adam Marcus in the latest (March, 2008) issue of Anesthesiology News.

But wait, it gets better.

"The number of visits to sites unrelated to work rose by half a percent after computer users were explicitly warned that the OR machines — which [also] hosted the hospital's information management system — were being monitored.

And before you say that the anesthesiologists at CHOP must not be very bright, know this: CHOP is considered one of the premier children's hospitals in the U.S., with fellowships there among the most prized in the nation.

Both the case load and degree of difficulty of patients presenting for anesthesia there are extreme.

So if this kind of thing is going on at this high-powered tertiary-care center, one can imagine what's happening at more typical community hospitals with more "ordinary" cases.

Marcus continued, "A major limitation of the study, the researchers acknowledged, was that it did not record whether patients were in the ORs when the staff were using the computers.... 'Even so, the utility of Internet access in the operating room is demonstrated by the fact that nearly half of browser events were [work-related],' they wrote."


I see no reason — zero, nada, zilch — why Internet access should be available to an anesthesiologist in the OR.

The possibility of gaining information that might aid in caring for the patient on the table is far smaller than the chance of that individual being harmed as a result of misdirected attention to Google News or YouTube.

March 19, 2008 at 10:01 AM | Permalink


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As chair of our intraoperative EMR project I have had a lot of experience with this issue. Our anesthesia teams have full internet access throughout the perioperative period. On our intranet site, we a protocols, drug information, and so on. On the internet, there is also much information that has been found to be very useful in caring for our patients.

When in-room clinicians are found to be accessing the internet in a manner inconsistent with the current patient care requirements, we deal with the individual. We expect our clinicians to be professionals at all times. Part of that is to treat them as adults.

In my view, it makes no more sense to block internet access than it does to outlaw newspapers in a hospital setting as a means to prevent anesthesiologists from reading the newspaper in the OR.

For what it's worth - this strategy overall has worked very well. It's also self-identified individuals who should not be caring for our patients.


Posted by: JPA | Mar 24, 2008 9:29:49 PM

Concur with Ray - as important as the anesthesiologist's job is, it is too easy for them to drift mentally from the task at hand, especially during long procedures when it's most important for them to stay with it.

Let's just hope they're professional enough to keep one eye on the vitals.

Posted by: Joe | Mar 24, 2008 2:30:13 PM

Anything to keep the anesthesiologist awake.

It must be annoying to be woken up to beeping alarms and funny dressed people yelling at each other in panic.

Posted by: Ray | Mar 20, 2008 8:14:42 AM

Actually, a lot of directly-relevant material is available through online applications for doctors in the middle of doing their job. Some (paid) web applications serve up whole reference books of information with easily searchable content. It's a pretty big business (which I have seen peripherally). It's available for Anesthesiologists, ER workers, and more.

Posted by: Lafe | Mar 19, 2008 12:03:12 PM

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