According to results from a survey published in the March issue of Anesthesia & Analgesia, the official journal of the International Anesthesia Research Society (IARS), over 80% of anesthesiologists have been involved in a fatal or serious incident to a patient during a surgical procedure.
New research indicates that these catastrophic events can have considerable and lasting effects on anesthesiologists and other professionals, who could benefit from time and support in order to recover from the incident.
Dr. Farnaz M. Gazoni of the University of Virginia Health System, Charlotte, who led the study, explained:
"These emotional and potentially cognitive effects can have repercussions not only for the physician involved but also, conceivably, for patients subsequently cared for."
To a nationwide sample of anesthesiologists, the team sent a survey about surgical catastrophes - events resulting in death or injury of a patient. The researchers found that 84% of the 659 respondents have been involved in a surgical catastrophe. Over an entire career this works out as an average of 4.4 incidents.
Over 70% of respondents said they experienced:
- Reliving of the event
- and the majority reported that they felt personally responsible for the injury or death of the patient, even if they believed the event was unpreventable
Only 7% of anesthesiologists were given time of work after the catastrophic event, while the majority had to continue with their work. Two-thirds of respondents reported that the believed their ability to care for patients was compromised in the hours following the incident. In addition, the majority reported that it would have been helpful after the incident to receive some sort of formal debriefing.
Prior studies have demonstrated that the injury or death of a patient is major source of stress for doctors, however, this study is the first to focus on surgical catastrophes involving anesthesiologist in the United States.
Dr. Gazoni and colleagues conclude:
"A perioperative catastrophe may have a profound and lasting emotional impact on the anesthesiologist involved and may affect his and her ability to provide patient care in the aftermath of such events."
A report by Drs. Timothy W. Martin of University of Arkansas for Medical Sciences, Little Rock, and Raymond C. Roy of Wake Forest University School of Medicine, Winston-Salem, N.C., reveals that surgical catastrophes may have additional victims as well.
As demonstrated in the study, these catastrophic events can make anesthesiologists the "second victim" of the event as a result of the lasting emotional impact it has on them. Furthermore, subsequent patients could become the "third victims" as many anesthesiologist are required to continue working - even though they believe their ability to care for patients is compromised.
According to Dr. Martin and Dr. Roy, the study indicates some "new imperatives" in the way health care organizations respond to catastrophic events.
Martin and Roy, feel that after being involved in a surgical catastrophe, anesthesiologists (and other professionals) should probably not be allowed to return to patient care duties immediately following the incident. In addition, they suggest anesthesiologists should be regularly monitored for signs of long-term psychological impairment, and that there should be some type of formal mental health screening following the event.
Written by Grace Rattue