Over the weekend just gone, Chris Nickson of Lifeinthefastlane threw down a challenge – the idea of a debate of ‘real anaesthetists don’t need checklists’ between Dr Minh le Cong and myself at next year’s SMACC14 conference on the Gold Coast (#SMACCGOLD).
Not withstanding the obvious inequalities between Minh’s masterful martial arts technique and my more traditional wrestling style, I reckon this will be a kick ass debate and lead nicely into some breakout discussions.
It’s no secret that I am a fan of checklists and other cognitive aids to help us in our work. I;ve been blogging about this since my post on ‘aviation & anaesthesia’ back in 2011 at the old KIDOCs blogsite (http://ki-docs.blogspot.com.au/2011/11/anaesthesia-aviation.html) and linking to usual resources see ‘Resources’ menu tab above)
Familiarity breeds contempt, and there is a benefit to introducing checklists into everyday routine BUT HIGH RISK procedures
– the WHO Surgical Checklist (more than the standard ‘surgical time out’ should incorporate checks in anaesthesia room, before knife-to-skin and before leaving the OT)
– an RSI kit dump and challenge-response checklist, as used by many retrieval services but with application to occasional intubators in the ED, ICU and rural environment
– checklists for management of crises, in OT, in ED, in Labour Ward
Not only that, use of checklists fosters teamwork, humility, discipline rather than the usual independence, self-sufficiency and autonomy that underlies most medical training.
Listen to Atul Gawande talking about ‘the checklist manifesto’ (thanks to Dr Stefan Mazur of medSTAR SA for getting on board with Twitter and sharing this link)
Meanwhile, bring it on…