SAFE PRACTICE
One approach to safe practice involves having complete, efficient
check lists to consult repeatedly as a case progresses. These should be checklists
that the anesthesiologist is accustomed to going through during every case. Vigilance,
a word that years ago was used more commonly among anesthesiologists, now describes
the virtue of numerous electronic monitors and alarms in the operating room. However,
there are no electronic monitors to tell the anesthesiologist where the nearest fire
extinguisher is, where oxygen shut-off valves are, where a grounding pad has been
placed, or where a surgeon may be able to cause a burn to a patient by suddenly placing
a very hot item on top of the drapes. If only checklists are used, there is the
risk of "only finding what one looks for, only recognizing what one knows."[57]
Safe practice involves
going through checklists while also being vigilant for new problems. In the Key
Points section, I propose the minimal general guidelines for safe electrical practice,
recognizing that many anesthesiologists will add refinements and elaborations.
