anesthesia
replying to s76 heavy, the anesthetist who is more senior has to take the major responsibilty, perhaps like a Captain. but like aircrew, the actual monitoring/ manangement of the patient is shared. in one hour , i will be with a more senior anesthetist. we will be putting a patient to sleep for a big spine operation which may last about four hours. during this , both of us will be together . however at times , he or i will dissappear for coffee breaks, either for ourselves , or to relieve other anesthetist working in other operating rooms. in this situation , the handover of information is very clear ... eg brief medical history , how things are going , drugs given , blood loss etc. the person about to take control will review the charts and then say he/she is happy to take over.
the problem arises when there are two anesthetists. say i have my coffee and return to theater . now its me and boss who are looking after the patient. in the current system , both of us pay attention . but this is dangerous as each thinks the other will be looking. this is where i want to introduce a language to indicate who is actively looking at the patient . the first step is that i have developed a "instrument" scan ...you can see it at www.rascan.com . if you do visit , see the introduction.
like the clipboard suggested , i thought of a clip or badge or something like that (brightly coloured). the badge indicating who is actively watching /flying the patient. the problem is possible transfer of infection . the bagde or similar thing might transfer infection.
at the moment , i am considering for a start to give names equivalent to pilot flying and non flying. i have decided to call the anesthetists actively mananging the patient as alpha one and the other one to be called alpha two . ( alpha is to replace our rather difficult to say title anesthetist, A =Anesthetist = Alpha).
Then i can envisage the hand over like this. the flying anesthetist will say to the other , "you are alpha one". The one taking over will reply "i am alpha one".if the one who has relinquished control wishes , he / she could answer "i am alpha two.
the problem with medical practise is that it is slow to change. so whatever measures are introduced , they have to be simple and practical.
thankyou again for your replies and i hope to hear more.
prasanna