Technology: A Friend or Foe? Do Electronic Health Records Increase Burn Out Amongst Anaesthesiologists?

Abstract

3D total laparoscopic hysterectomy in progress under general anaesthesia; steep head low, everyone delighted to see the 3D picture on screen with the goggles including the anaesthesia resident. I enter the OT (needless to say that as a senior one has to supervise more than one OT at a time). The high-end Anaesthesia machine standing tall inside the OT with all the sophisticated monitoring gadgets. I look at the ventilatory pattern on monitor: etCO2 graph upsloping with a value of 42mm of Hg, airway pressure 26mm of Hg and rising! I ask a rhetoric question to my resident as to where his attention is and to my dismay, he expresses his dissatisfaction that the monitors neither give us alarms against rising etCO2 or airway pressure nor do they warn us about changing capnograph slopes!! I am appalled. THROWBACK- Not long time ago when we were residents, we used our ‘educated hands’ to monitor the airway pressure with manual ventilation. Differential diagnosis of tight bag used to be one of the favourite questions seniors used to ask us during on-table teaching. We had no etCO2 monitor then (the mandatory minimum monitoring standard); leave alone the hi-tech ventilatory gadgets and associated airway gas monitoring. Sooner the educated hand was replaced by ventilator and arguments will continue whether to declare this as a loss of clinical skill; an unresolved riddle due to paucity of evidence. The least that I can say is with the hand on pulse and bag in hand, we used to ‘stay connected’ to the patient; with the technical advances this connection got lost. Does this make the ventilator and the advances in monitoring evil?? Obviously not. The advances in science and technology are not only for our comfort but they also play a pivotal role in improving patient’s safety and offering better patient care. Over years surgery has advanced enormously and most of these developments are attributed to advances in the field of anaesthesia which has evolved itself from the Stone Age t