Biometric Analysis of Surgeons' Physiologic Responses During Surgery.

BACKGROUND: Much has been written from the social science perspective surrounding surgeons' stress and burn out. The literature is sparse in reference to scientific investigations of the hemodynamic effect of that stress. This prospective clinical study quantifies the physiologic impact of performing surgery upon the acute care surgeon. METHODS: Over 2.5 years, monitoring devices were affixed to surgeons prior to entering the operating room, and physiologic variables were documented every 30 minutes. Qualifying cases were projected as being greater than 2 hours with a baseline preoperative measurement obtained. Variables recorded included blood pressure (BP), heart rate (HR), rate pressure product (RPP), oxygen saturation (O2 sat), and end-tidal carbon dioxide (ET CO2). RESULTS: Statistically significant differences (P < .05) were found between baseline data to the maximum recording during the surgical operation for: BP (min 101 ± 6.6 (mmHg)-max 117 ± 5.1 (mmHg)), HR (min 70.5 ± 6.2 (bpm)-max 83.7 ± 9.0 (bpm)), O2 sat (min 97 ± 2.0 (%)-max 100 ± 0.22(%)), and ET CO2 (min 34.1 ± 1.15 mmHg-max 38 ± 1.7 mmHg) (P < .0001). The RPP ranged from 10.49 mmHg/min to 15.88 mmHg/min with a mean of 14.00 mmHg/min. DISCUSSION: The practice of surgery is considered demanding in training and lifestyle in comparison to other medical specialties. This data is among the first to demonstrate the negative physiological impact of surgery upon the metabolic demand of the surgeon. The longitudinal implications of increased physiologic demand over time may have cardiovascular and cerebrovascular consequences.

American College of Surgeons Committee on Trauma "Stop the Bleed Program": Quantifying the Impact of Training Upon Public School Educators Readiness.

BACKGROUND: School violence continues to afflict our educational institutions. In response, an institutional initiative was launched to train educators and school support staff in life-saving skills aimed at hemorrhage control. METHODS: The American College of Surgeons Committee on Trauma "Stop the Bleed" (STB) Program was promoted as a quality improvement initiative to schools within the geographic catchment area of this Level I Trauma Center. Participants were given the opportunity to take precourse, and postcourse confidence inventories using a Likert Scale. Statistical analysis of the 324 precourse to postcourse evaluations measuring change in confidence was used to evaluate improvement in readiness of school systems to respond in mass casualty incidents. RESULTS: Students enrolled in the STB Program were offered the opportunity to assess their confidence precourse and postcourse in reference to 7 questions. Precourse and postcourse Likert Scale inventories were compared and analyzed to assess the strength of the improvement in confidence using Student's t-test, where P < .05 is statistically significant. Students demonstrated improvement (P < .006) that was statistically significant across all 7-question relating to enhance confidence postcourse compared with the precourse. DISCUSSION: This STB quality initiative has demonstrated a statistically significant improvement in the confidence of teachers and school personnel to render lifesaving care in the event of a mass casualty or isolated incident of life-threatening hemorrhage. These results support the validity of the training in making a difference in this subpopulation of responders.