Noise Levels in the Operating Room
UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD BETHESDA United States
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Monitoring during anesthesia improves patient outcome by increasing the anesthesia providers awareness of actual and potential problems. Lack of vigilance has been reported to be responsible for up to 30 of major problems occurring during anesthesia. Excessive noise in the environment is a factor that may decrease provider vigilance, and the Anesthesia Patient Safety Foundation has recently identified noise in the operating room OR as a major area of concern. In this study the level of noise in one OR was measured and correlations between noise levels and anesthesia providers ability to hear critical patient monitors are described. The four-week study took place in an orthopedic OR of a 90-bed military hospital in the Midwest. Noise was measured continuously from the initial set up of the room to the completion of the last procedure of the day. Episodes in which the audible pulse oximeter monitor tone set at 50 volume was difficult to hear or could not be heard at all due to the high levels of noise were documented. Noise levels ranged from a minimum of 46.8db A to a maximum of 95.0db A. Average levels of noise Leq ranged from 60.1 to 69.4db A. Baseline monitor tones and alarms ranged from 55-75db A. NIOSH standards recommend the decibel level not exceed 85db A for an eight-hour work period or 91db A for more than two hours. Basic levels of noise measured in the OR did not exceed NIOSH standards. Determinations regarding the ability of noise levels to cause difficulty in hearing monitor tones and alarms were inconclusive. The role noise may play on decreasing anesthetist vigilance is still undetermined. Further study that focuses on actual noise levels and anesthetist task performance is needed.