Human Error in Dynamic Medical Domains 1

Abstract

This chapter considers human error in anesthesiology and its close relative, intensive care. It focuses on the behaviors of operational personnel, it is appropriate to address briefly the issue of organizational structure and managerial decision making. Human error, for its part, is a rather ambiguous term encompassing a variety of human behaviors, wherein the definition of error is controversial. The chapter focuses on the details of the performance of anesthesia personnel. Anesthetists share an aphorism with pilots that describes the work environment: "hours of boredom, moments of terror." Every patient who has surgery requires some kind of anesthesia. There are three types of anesthesia: local, regional, and general. Each patient must be evaluated by an anesthetist prior to beginning anesthesia. Anesthesia is initially induced with an intravenous induction agent that acts very rapidly and places the patient in a relatively deep level of anesthesia.