INTRAOPERATIVE NOISE POLLUTION AND ITS EFFECT UPON COMMUNICATION DURING PERCUTANEOUS NEPHROSTOLITHOTOMY

You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2015MP30-10 INTRAOPERATIVE NOISE POLLUTION AND ITS EFFECT UPON COMMUNICATION DURING PERCUTANEOUS NEPHROSTOLITHOTOMY Kristene Myklak, Hayley Mowery, Muhannad Alsyouf, Roger Li, Michelle Lightfoot, Chase Atiga, David Tryon, Herbert Hodgson, Carol Conceicao, Daniel Faaborg, Javier L. Arenas, Nazih Khater, Herbert C. Ruckle, D. Daniel Baldwin, and D. Duane Baldwin Kristene MyklakKristene Myklak More articles by this author , Hayley MoweryHayley Mowery More articles by this author , Muhannad AlsyoufMuhannad Alsyouf More articles by this author , Roger LiRoger Li More articles by this author , Michelle LightfootMichelle Lightfoot More articles by this author , Chase AtigaChase Atiga More articles by this author , David TryonDavid Tryon More articles by this author , Herbert HodgsonHerbert Hodgson More articles by this author , Carol ConceicaoCarol Conceicao More articles by this author , Daniel FaaborgDaniel Faaborg More articles by this author , Javier L. ArenasJavier L. Arenas More articles by this author , Nazih KhaterNazih Khater More articles by this author , Herbert C. RuckleHerbert C. Ruckle More articles by this author , D. Daniel BaldwinD. Daniel Baldwin More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.592AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Tools and equipment utilized during endourologic surgery contribute significantly to noise pollution in the operating room (OR) during percutaneous nephrostolithotomy (PCNL). The purpose of this study was to determine OR baseline noise and noise contributed by endourologic equipment during PCNL; then, to determine the effect of this noise upon the effectiveness of communication. METHODS Ambient noise in the operating room was measured using a digital decibel meter. Noise levels were determined by the sequential addition of normal conversation, high-pressure suction, ultrasonic lithotripter, and background music. Three subjects—the surgical assistant (0.8m from the surgeon), anesthesiologist (1.8m), and the circulator (2.5m) were placed in the operating room to simulate positioning during PCNL. Five trials of 20 different medical words/phrases were spoken by the surgeon. Trials were performed with three sound categories. The first category included ambient sound alone, the second included ambient sound, suction and lithotryptors, and the third included ambient sound, suction, lithotripsy and loud music. In addition, the OR noise was compared to commonly encountered environmental noise; including cars (n=12) and trucks (n=18) driving 40 mph at 30 ft, and freight trains (n=8) traveling 55 mph at 30 and 45 feet. Statistical analyses were performed using a student t-test. RESULTS The average baseline noise was 53.49dB(A). As conversation, suction/lithotripsy, and music were added, noise levels were 61.82dB(A), 77.96dB(A), and 87.33dB(A), respectively. At baseline noise, the surgical assistant, anesthesiologist and circulating nurse correctly recorded 100%, 100% and 96% of the words, respectively. The correct response rate by the subjects decreased to 97%(p=0.172), 81%(p<0.001) and 56%(p<0.001) with suction/lithotripsy and 90%(p=0.006), 48%(p<0.001) and 13%(p<0.001) with suction/lithotripsy/music. By comparison, total PCNL noise (conversation/suction/lithotripsy/music) [87.33 dB(A)] was louder than the measured car [67.8 dB(A); p<0.001] and pickup truck noise [69.2 dB(A); p<0.001] but similar to a freight train at 30 feet [82.2 dB(A); p=0.44]. CONCLUSIONS Endourologic instruments and music utilized during PCNL may significantly contribute to noise pollution in the operating room environment and this noise may significantly degrade the effectiveness of communication. An understanding of the role that noise and distance play in affecting the success of communication may reduce operating room errors and patient complications. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e351 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristene Myklak More articles by this author Hayley Mowery More articles by this author Muhannad Alsyouf More articles by this author Roger Li More articles by this author Michelle Lightfoot More articles by this author Chase Atiga More articles by this author David Tryon More articles by this author Herbert Hodgson More articles by this author Carol Conceicao More articles by this author Daniel Faaborg More articles by this author Javier L. Arenas More articles by this author Nazih Khater More articles by this author Herbert C. Ruckle More articles by this author D. Daniel Baldwin More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...