Background Anesthesiology requires performing visually-oriented procedures while monitoring auditory information about a patient’s vital signs. A concern in operating rooms environments is the amount of competing information and the effects that divided attention have on patient monitoring, such as detecting auditory changes in arterial oxygen saturation via pulse oximetry. Methods We measured the impact of visual attentional load and auditory background noise on the ability of anesthesia residents to monitor the pulse oximeter auditory display in a laboratory setting. Accuracies and response times were recorded reflecting anesthesiologists’ abilities to detect changes in oxygen saturation across three levels of visual attention in quiet and with noise. Results Results show that visual attentional load substantially impacts the ability to detect changes in oxygen saturation levels conveyed by auditory cues signaling 99 and 98% saturation. These effects are compounded by auditory noise, with up to a 17% decline in performance. These deficits are seen in the ability to accurately detect a change in oxygen saturation and in speed of response. Conclusions Most anesthesia accidents are initiated by small errors that cascade into serious events. Lack of monitor vigilance and inattention are two of the more commonly cited factors. Reducing such errors is thus a priority for improving patient safety. Specifically, efforts to reduce distractors and lower background noise should be considered during induction and emergence, periods of especially high risk, when anesthesiologists must attend to many tasks and are thus susceptible to error.

A nesthesiology requires intense vigilance, multitasking, aural perception, communication skills, and critical decision making. In the operating room (OR) environment, the amount of competing information and noise can have considerable impact on the anesthesiologist's ability to perform cognitive tasks. The pulse oximeter is one of the most important monitors used, and changes in the patient's physiologic parameters often require auditory perception of changes in the pitch of the monitor. With the activity

The pulse oximeter is a critical monitor in anesthesia practice designed to improve patient safety. Here, we present an approach to improve the ability of anesthesiologists to monitor arterial oxygen saturation via pulse oximetry through an audiovisual training process. Fifteen residents' abilities to detect auditory changes in pulse oximetry were measured before and after perceptual training. Training resulted in a 9% (95% confidence interval, 4%-14%, P = 0.0004, t(166) = 3.60) increase in detection accuracy, and a 72-millisecond (95% confidence interval, 40-103 milliseconds, P < 0.0001, t(166) = -4.52) speeding of response times in attentionally demanding and noisy conditions that were designed to simulate an operating room. This study illustrates the benefits of multisensory training and sets the stage for further work to better define the role of perceptual training in clinical anesthesiology.

The most basic needs to provide essential surgery are now present in LICs and LMICs. Many more resources are needed to ensure access to safe surgery and anesthesia. The next steps to provide essential surgery must include common solutions for access to surgery and anesthesia, and an evaluation of patient safety in these endeavors through the perioperative mortality rate.