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Distraction: Three Things Tuesday

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On Saturday I am presenting Distraction is Deadly at the NAEMSE symposium. My slides for the presentation and the handout will post on EverydayEMSTips.com early Saturday morning.

There are three types of distraction:

1. Manual – taking your hands off a task. For example, taking your hands off the wheel to key the radio or reach for a cup of coffee.

2. Visual – taking your eyes off a task. For example, looking down at a paper map or GPS screen.

3. Cognitive – taking your mind off a task. For example, thinking about your childcare needs as you assess a late call patient.

Many distractions are a combination of manual, visual, and cognitive. Text messaging is a perfect storm of distraction since it combines a manual act (keying the phone), visual act (looking at the screen), and cognitive act (composing a message).

Last week this report was submitted to E.V.E.N.T. and is a great example of how distraction led to a close call medication error.

Description: Close-Call.  While preparing two medications for patient administration, the medic preparing them started drawing one from a vial of Adenocard, 6 mg/2 mL when they intended to prepare Zofran, 4 mg/2 mL.  The other medic caught the mistake while it was being withdrawn from vial.   No patient harm.

Cause: Crew reviewed and believes that the primary contributor was multiple distractions from too many 1st responders & their wanting to converse while medic was working on preparing multiple syringes.  Both correct med. syringes were then properly labeled & medication check procedures completed before administration.  Confused vials were also the same physical size.

The patient care compartment, especially when medication is being prepared and administered, should be as distraction free as possible.

What do you do that causes distraction in the patient care compartment? 

How can you minimize distraction during critical procedures?