Go/no-go decision in anaesthesia: wide variation in risk tolerance amongst anaesthetists

British Journal of Anaesthesia
P R GreigC Vincent

Abstract

The variability in risk tolerance in medicine is not well understood. Parallels are often drawn between aviation and anaesthesia. The aviation industry is perceived as culturally risk averse, and part of preflight checks involves a decision on whether the flight can operate. This is sometimes termed a go/no-go decision. This questionnaire study was undertaken to explore the equivalent go/no-go decision in anaesthesia. We presented anaesthetists with a range of situations in which additional risk might be expected and asked them to decide whether they would proceed with the case. An electronic questionnaire was distributed to anaesthetic colleagues of all grades in one National Health Service Trust. Eleven scenarios, all drawn from critical incident data, were presented. Participants were invited to consider whether they would proceed, how they would modify their anaesthetic technique, and to predict whether a colleague with similar experience would make the same decision. Textual responses were analysed qualitatively. The scenario response rate was 28%. Consultants were significantly more likely to proceed than trainees. In no scenario was there absolute agreement over whether to proceed, even in scenarios where national guidel...Continue Reading

References

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Citations

Apr 13, 2018·Journal of Agromedicine·Amy Irwin, Jill Poots
Mar 20, 2020·Minerva anestesiologica·Eric P Deflandre, Benjamin X Javillier
Jul 3, 2018·Anaesthesia and Intensive Care·A SilversL Jolevska
Dec 7, 2018·International Anesthesiology Clinics·Tinh T HuynhIan H Black
Apr 14, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Laura V DugganHilary P Grocott
Feb 13, 2021·Archives of Disease in Childhood·Charles A VincentMike English
May 17, 2017·British Journal of Anaesthesia·J M Ehrenfeld, P M Fleischut

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