title: A novel vibrotactile display to improve the performance of anesthesiologists in a simulated critical incident.
abstract: BACKGROUND
  Current methods of information transfer in the operating room between monitor and anesthesiologist rely on visual and auditory modalities. These modalities can easily become overloaded in a high cognitive workload situation, such as in a critical incident. The use of vibrotactile communication has been shown to improve information transfer in other high cognitive workload environments such as aviation. We designed a novel waist-mounted vibrotactile display to be worn by the anesthesiologist to test if a vibrotactile display could improve the clinical response time to begin treating a simulated case of anaphylaxis when compared with a group using traditional information displays. In addition, we evaluated differences in situational awareness (SA) between the two groups.
  
  
  METHODS
  Twenty-four volunteer anesthesiologists were randomized to diagnose and treat a simulated case of anaphylaxis using the vibrotactile display and standard monitoring (vibrotactile display group) or standard monitoring alone (control group). The time taken to administer epinephrine was measured, and objective post hoc analysis of participant SA was performed.
  
  
  RESULTS
  Participants in the vibrotactile group took 4.08 min (95% CI = 1.22) to deliver definitive treatment compared with 7.21 min (95% CI = 2.07) for the control group (P < 0.05). Despite the reduced time to treatment, no improvement in SA was measured.
  
  
  CONCLUSIONS
  Our study provides evidence that vibrotactile communication can reduce response time to critical incidents.
authors: Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver General Hospital, British Columbia, Canada. smford1@gmail.com
authors: Simon
authors: S
authors: Ford
authors: Jeremy
authors: J
authors: Daniels
authors: Joanne
authors: J
authors: Lim
authors: Valentyna
authors: V
authors: Koval
authors: Guy
authors: G
authors: Dumont
authors: Stephan K W
authors: SK
authors: Schwarz
authors: J Mark
authors: JM
authors: Ansermino
mesh_terms: D000707:Anaphylaxis / Q000503:physiopathology*; D000776:Anesthesiology / Q000592:standards*; D003205:Computing Methodologies; D016638:Critical Illness; D006309:Hearing; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D016544:Patient Simulation; D011930:Reaction Time; D014110:Touch; D014732:Vibration; D014785:Vision, Ocular