The Effect of Noise Distraction on Emergency Medicine Resident Performance During Intubation of a Patient Simulator

Getto, Leila; Marco, Debra; Papas, Mia A.; Fort, Charles W.; Fredette, Jenna

doi:10.1016/j.jemermed.2015.09.048

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…9 However, the difference is more likely due to our methodology. Our providers were required to assemble the laryngoscope, stylet and tube, inflate the cuff, and deliver a bag valve mask breath before the timing ended, whereas Getto et al's 5 residents began by picking up the C-MAC laryngoscope and ended when the tube entered the cords without any cuff inflation nor breath delivery.…”

Section: Discussionmentioning

confidence: 99%

“…4 However, noise levels in the ED can fluctuate to higher decibels that may be challenging to predict on a minute-to-minute basis, because of a variety of factors. 3 In the specific realm of ED intubations, Getto et al 5 demonstrated that increasing noise levels did not affect intubation times among residents. Whether noise levels affect more experienced providers is unknown, and we sought to answer this question through both objective and subjective evaluation of intubation performance.…”

mentioning

confidence: 99%

“…In the specific realm of ED intubations, Getto et al 5 demonstrated that increasing noise levels did not affect intubation times among residents. Whether noise levels affect more experienced providers is unknown, and we sought to answer this question through both objective and subjective evaluation of intubation performance.…”

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confidence: 99%

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Impact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers

Salzman

2019

Pediatr Emer Care

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Background:The emergency department is a stressful workplace environment with environmental stimuli and distractions, including noise. This has potential effects on perceived stress for providers and critical procedure performance.Objective: This study aimed to characterize the impact of environmental noise levels on the time to intubate, the quality of intubation, and physiologic stress response in pediatric emergency department providers.Methods: This was a randomized control simulation-based study in which experienced pediatric providers intubated an adult manikin 3 times while experiencing 3 different ambient noise levels (60, 75, 80 dB) in random order. Participants' times to intubate were measured, as was the endotracheal tube depth. The quality of each intubation attempt was assessed via video review against a standardized checklist. Lastly, participants' heart rates were monitored in real time to assess for physiologic stress response. Differences in performance were analyzed using a repeated-measures analysis of variance.Results: No significant difference was found between noise levels and time to intubate (P = 0.19), although each subsequent attempt shortened the time to intubate (P = 0.01). Physiological heart rate changes did not differ by noise level (P = 0.35). Subjectively, "time and economy of motion" and "overall performance" did not differ by noise level but did improve for each subsequent attempt number (P < 0.046).Conclusions: Intubation performance improved with attempt number, but no differences in performance were seen between noise levels. This suggests that rehearsing and practice impacts performance more than environmental noise levels.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Impact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers

Salzman

2019

Pediatr Emer Care

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“…Previous measurements of noise in ED(13-15) have demonstrated noise levels (50 to 70 dB) high enough to raise concern about communication interference and subsequent disruption of complex procedures(16, 17), teaching(18) and decision-making (19-20). The highest noise levels (a medical helicopter landing or use of an orthopaedic cast saw) were above recommended occupational exposure levels(21) suggesting that protective equipment should be used.…”

Section: Introductionmentioning

confidence: 99%

Background noise in an Emergency Department: an observational study from staff and patient perspectives

Emar

Smith

Coats

2022

Preprint

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Background and importanceNoise is a contributing factor to mis-communication, poor sleep patterns and stress in healthcare. There has been little research on noise in the Emergency Department (ED).Objective(s)(1) To identify the noise levels experienced by staff and patients in different areas of an emergency department over the 24 hour cycle, (2) to examine the impact of cubicle doors on the background noise experienced by the patient, and (3) to assess the impact of monitor alarms on staff and patient noise levels.DesignObservational study.SettingA large urban teaching hospital Emergency Department.Measures and analysisUsing a standard protocol monitoring of staff and patient experience of noise was carried out in 3 areas of the ED (a resuscitation room, an area of patient cubicles with solid doors and and an area of patient cubicles with curtains).The overall distributions of noise levels in each area were described and circadian variation plotted. The proportion of time that background noise was above key cutoff values known to impair communication was calculated (45dB and 65dB).Non-parametric methods were used to compare: (1) a patient cubicle with curtains compared to a solid door, (2) having the door open or closed, and (3) staff and patient exposure a monitor alarm.Main resultsNoise was greater than 45dB for staff between 76% and 96% of the time (30% to 100% for patients). There was little difference across the 24hr cycle. A door decreased the noise experienced by patients, but only if left closed. In the resuscitation rooms monitor alarms were much louder for patients than for staff.ConclusionNoise levels likely to impair communication are present in the ED for most of the time. Staff awareness and improved design of both buildings and equipment might mitigate this negative acoustic environment.

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“…Although the training of hands-on skills in veterinary education has traditionally relied on the use of live animals, the use of simulated environments in human medicine are proven alternatives to promote proficiency (Hettinger & Haas 2003;Getto et al 2016).…”

Section: Introductionmentioning

confidence: 99%

A low-cost portable simulator of a domestic cat larynx for teaching endotracheal intubation

Clausse

Nejamkin

Bulant

et al. 2020

Veterinary Anaesthesia and Analgesia

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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The Effect of Noise Distraction on Emergency Medicine Resident Performance During Intubation of a Patient Simulator

Cited by 6 publications

References 17 publications

Impact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers

Impact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers

Background noise in an Emergency Department: an observational study from staff and patient perspectives

A low-cost portable simulator of a domestic cat larynx for teaching endotracheal intubation

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