Interruptions and distractions in the trauma operating room: understanding the threat of human error.

OBJECTIVE: To understand the human factor as a threat to the security of trauma patients in the operating room, bringing to the operating room some important rules already applied in the field of aviation.
METHODS: The sample included 50 cases of surgical trauma patients prospectively collected by observers in shifts of 12 hours, for six months in a Level I trauma center in the United States of America. Information regarding the type of trauma, severity score and mortality were collected, as well as determinants of distractions / interruptions and the volume of noise in the operating room during surgery.
RESULTS: There was an average of 60 interruptions or distractions during surgery, most often triggered by the movement of people in the room. In more severe patients (ISS> 45), subjected to damage control, the incidence of distractions was even greater. The average noise in the trauma surgery room was very high, close to the noise of a hair dryer.
CONCLUSION: Interruptions and distractions are frequent and should be studied by the trauma surgeon to develop prevention strategies and lines of defense to minimize them and reduce their effects.