title: Incidence and impact of distracting events during induction of general anaesthesia for urgent surgical cases.
abstract: OBJECTIVE
  Distractions and interruptions during clinical activities can decrease performance and increase the risk of error. The incidence and impact of distracting events on anaesthetic teams during the critical phases of general anaesthesia are unknown. The purpose of this study was to quantify and analyse the frequency, the source and the impact of these events during the period of induction of general anaesthesia.
  
  
  METHODS
  Twenty-nine anaesthetic team members participated in the study. Anaesthetic teams were videotaped during the induction period of a general anaesthesia. All videotapes were reviewed by two investigators using a scoring system in order to categorize the distracting events according to their origin, source, nature, duration, impact on patient and consequences on team activities. A total of 37 videotapes of general anaesthesia inductions for urgent surgical cases were analysed.
  
  
  RESULTS
  The results show that the sources of distracting events are multiple and diverse. Distracting events occurred frequently (median five per video) and at least one event was present for 39.5% of the total observed period. They had a significant impact on the activity of the team members during 21.8% of the total observed period and had a negative impact on patient management in one-fifth of the cases.
  
  
  CONCLUSIONS
  During the induction phase of general anaesthesia, distracting events are frequent and affect significantly the task at hand. Future research should design and implement preventive strategies to minimize the occurrence of unnecessary distracting events during this critical phase of anaesthesia when calm and vigilance should prevail.
authors.affiliation: Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. Georges.savoldelli@hcuge.ch
authors.forename: Georges L
authors.initials: GL
authors.lastname: Savoldelli
authors.forename: Juliette
authors.initials: J
authors.lastname: Thieblemont
authors.forename: François
authors.initials: F
authors.lastname: Clergue
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Waeber
authors.forename: Alain
authors.initials: A
authors.lastname: Forster
authors.forename: Philippe
authors.initials: P
authors.lastname: Garnerin
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data; D001288:Attention; D002983:Clinical Competence / Q000592:standards; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D019300:Medical Errors / Q000517:prevention & control; D010348:Patient Care Team / Q000592:standards / Q000706:statistics & numerical data; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors