Recognizing an Emergency in the OR
Emergency events can occur at any time and during any surgery, including the most routine. Perioperative nurses must be attentive to cues that a patient’s status may be changing and prepare to support the surgical team and anesthesia care provider during an emergency.
Situational Awareness
In all emergencies in the perioperative environment, there are warnings that a patient’s status is beginning to change. The experienced perioperative nurse notices these cues and begins to prepare before a crisis occurs.
Situational awareness is defined as an ability to see the big picture in an environment that is constantly evolving. Because the perioperative environment is reliant on the whole team and not an individual, SHARED situational awareness is the term used.
Shared situational awareness occurs when perioperative team members understand each other’s activities and how they impact common perspectives and goals related to caring for the patient. This may be done through direct communication or through observation. Based on the information gleaned, team members can react quickly and respond to changing and emergent situations.
(Gillespie et al., 2013)
💬 Communication Highlight
As a novice perioperative nurse, it is important to observe the room. You may be watching a routine case but notice that changes are occurring. Perhaps the anesthesia machine is alarming constantly, the pulse oximeter begins to quicken (or slow), or you notice that the surgeon requires more sponges than usual to control bleeding. Being aware of these changes and other cues, such as the anesthesia care provider asking you to order blood STAT, should automatically put you on alert that the patient’s status may be changing, and they may need additional assistance. Noticing, and most importantly, acting on these cues demonstrates critical thinking and situational awareness.