An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members

Ward, M.K.; Yam, Cheryl M H; Palejwala, Zehra; Wallman, Karen; Taggart, Sarah M.; Wood, Fiona; Parker, Sharon K.

doi:10.1097/sla.0000000000004598

Cited by 8 publications

(11 citation statements)

References 37 publications

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“…Interestingly, other studies have attempted to uncover effective ways of maintaining patient core body temperature while maintaining a more comfortable OR ambient temperature for OR staff as increased OR temperatures may have negative impacts on staff performance and OR sterility. 5,26 Relatively newer methods of intraoperative thermal regulation include intravascular, esophageal, and skin surface modalities. 5,16,17,[27][28][29][30] As cool IV fluids have been identified as a risk factor for the development of intraoperative hypothermia, the use of IV warming catheters has been shown to confer the ability to decrease ambient temperatures to 23.9-29.4°C with conservation of patient normothermia among patients with ≥25% TBSA burns.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Ambient Temperature Control Across Various Care Settings on Outcomes in Burn Patients: A Review Article

Kinter

Alfaro

Sutherland

et al. 2021

The American Surgeon

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Ambient/room temperature settings in burn treatment areas vary greatly due to a lack of evidence-based guidelines to direct care. While it is generally understood that ambient/room temperature impacts patient body temperature and metabolism, the ideal settings for optimizing patient outcomes are unclear. The literature assessing this topic is scarce, with many of the articles having significant limitations. We aim to summarize the current evidence for ambient/room temperature control, to address gaps in current reviews addressing this topic, and to elucidate topics requiring further research. PubMed and Google Scholar databases were queried for studies which evaluated the effect of the ambient/room temperature on burn patient core body temperature, patient metabolism, and outcomes among those treated in trauma bays, burn ICUs, and operating rooms. Although existing literature lacks sufficient patient outcome data regarding specific ambient/room temperatures, we highlight physiological processes that are impacted by changes in room temperatures in an effort to describe strategies that can allow for improved patient core body temperature control and outcomes in burn care settings.

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Section: Discussionmentioning

confidence: 99%

The Impact of Ambient Temperature Control Across Various Care Settings on Outcomes in Burn Patients: A Review Article

Kinter

Alfaro

Sutherland

et al. 2021

The American Surgeon

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“…Major burn surgeries (usually � 20% total body surface area [TBSA]) are typically conducted in ambient temperatures of 30-40˚C to prevent patients from developing intraoperative hypothermia [1]. This can improve patient outcomes; however, patient outcomes also depend on the cognitive function [2], manual dexterity/technical skills [3], and fatigue levels of surgical teams [4].…”

Section: Introductionmentioning

confidence: 99%

Higher operating theatre temperature during burn surgery increases physiological heat strain, subjective workload, and fatigue of surgical staff

et al. 2023

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Raising the ambient temperature of the operating theatre is common practice during burn surgeries to maintain the patient’s core body temperature; however, the effects of operating in the heat on cognitive performance, manual dexterity, and perceived workload of surgical staff have not been assessed in a real-world context. Therefore, the aim was to assess the real-time impact of heat during burn surgeries on staff’s cognitive function, manual dexterity, and perceptual measures (workload, thermal sensation, thermal comfort, perceived exertion, and fatigue) and physiological parameters (core temperature, heart-rate, fluid loss, and dehydration). Ten burn surgery staff members were assessed in CON (24.0±1.1°C, 45±6% relative humidity [RH]) and HOT (30.8±1.6°C, 39±7% RH) burn surgeries (average 150 min duration). Cognitive performance, manual dexterity, and perceptual measures were recorded pre- and post-surgery, while physiological parameters were recorded throughout surgery. HOT conditions did not significantly affect manual dexterity or cognitive function (p > .05), however HOT resulted in heat strain (increased heart-rate, core temperature, and fluid loss: p < .05), and increased subjective workload, discomfort, perceived exertion, and fatigue compared to CON conditions (p < .05). Cognitive function and manual dexterity were maintained in hot conditions, suggesting that operating in approximately 31°C heat is a safe approach for patient treatment. However, job burnout, which is positively correlated with perceived workload, and the impact of cumulative fatigue on the mental health of surgery staff, must be considered in the context of supporting an effective health workforce.

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“…Studies show that high noise levels from equipment in ORs can increase staff stress levels (Ward et al, 2020) and hinder staff communication, concentration, and coordination during surgery (Bayramzadeh & Aghaei, 2021; Keller et al, 2016; Padmakumar et al, 2017; Pennathur et al, 2013). Similar issues such as high ambient noise and noise-based interruptions are observed in hospital sonography environments which result in a high cognitive load for staff (Stigall-weikle et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Temperature is another sensory stimulus in complex healthcare environments that impacts patients and staff. Elevated temperature levels in ORs can negatively impact both staff self-rated subjective performance (Hakim et al, 2018) and executive functioning (Ward et al, 2020). Further, staff can perceive workload as higher than usual when working in a warm OR (Ward et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Elevated temperature levels in ORs can negatively impact both staff self-rated subjective performance (Hakim et al, 2018) and executive functioning (Ward et al, 2020). Further, staff can perceive workload as higher than usual when working in a warm OR (Ward et al, 2020). Temperature plays a significant role in environments such as trauma rooms and ORs where patients are susceptible to hypothermia (Alam et al, 2018; Engorn et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Sensory Stimuli on Healthcare Workers and Outcomes in Trauma Rooms: A Focus Group Study

Bayramzadeh,

Ahmadpour

2023

HERD

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Objective: This study investigated issues related to noise, lighting, and temperature in trauma rooms that impact patient care and staff performance. Background: Uncontrolled sensory stimuli can hinder healthcare delivery quality in trauma rooms. High noise and temperature levels can increase staff stress and discomfort as well as patient discomfort. Conversely, proper lighting can decrease staff stress levels and reduce burnout. Sensory overload in trauma rooms is a crucial concern, but no studies have been conducted on this issue. Method: Using a convenience sampling method, 65 trauma team members (e.g., surgeons, physicians, nurses) from six Level I trauma centers in the United States were recruited to participate in 20 focus groups. Focus groups were semi-structured and 1 hr long. Results: Staff covered issues related to communications and disruption from noise sources (e.g., equipment, conversations). Having control over lighting allows staff to change light intensity and facilitate their work during the resuscitation. A well-maintained temperature can provide patient comfort or reduce risk of hypothermia, given that patients can lose body heat rapidly due to loss of blood. Conclusion: Excessive sensory stimuli can result in disrupted communication, fatigue, and stress, making staff susceptible to errors. Staffs’ control over environmental conditions may lead to a more efficient, comfortable, and safer environment. Technology should be reliable and flexible to facilitate this.

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An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members

Cited by 8 publications

References 37 publications

The Impact of Ambient Temperature Control Across Various Care Settings on Outcomes in Burn Patients: A Review Article

The Impact of Ambient Temperature Control Across Various Care Settings on Outcomes in Burn Patients: A Review Article

Higher operating theatre temperature during burn surgery increases physiological heat strain, subjective workload, and fatigue of surgical staff

The Impact of Sensory Stimuli on Healthcare Workers and Outcomes in Trauma Rooms: A Focus Group Study

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