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Anesth Analg 2004;99:1450-1452
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000132545.19806.3B

TECHNOLOGY, COMPUTING, AND SIMULATION

Access Denied; Care Impaired: The Benefits of Having Online Medical Information Available at the Point-of-Care

Barry A. Finegan, MB FFARCSI, FRCPC

Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada

Address correspondence and reprint requests to Dr. B. A. Finegan, Department of Anesthesiology and Pain Medicine, 3B2.32 W. C. Mackenzie Health Sciences Center, Edmonton, Alberta, Canada, T6G 2B7. Address email to lm6{at}ualberta.ca

The availability of Internet-enabled computers in the operating room (OR) facilitates unparalleled physician access to current peer reviewed research, either in abstract or full text format, a development that provides physicians with an exciting opportunity to incorporate such findings into clinical practice at the point-of-care. In this report I describe how the availability of online peer reviewed medical literature altered, in one case a planned surgical procedure and, in the other, the interpretation by the anesthesiologist of the clinical significance of an intraoperative echocardiographic finding. In case one, a free, rather than an intact, internal mammary (IM) artery graft was placed to the left anterior descending coronary artery of a patient with renal failure and an ipsilateral upper extremity arteriovenous fistula. The change occurred after the full text results of a study indicating that steal could well occur during the initiation of dialysis if an intact IM was used were made available to the surgeon. In case two, the occurrence of mild central mitral regurgitation in a Carpentier-Edwards Perimount prosthetic mitral valve was confirmed to be a benign finding after a study detailing the long term performance characteristics of this valve was accessed online in the OR. The benefits and potential pitfalls of searching and interpreting online medical information are discussed.

IMPLICATIONS: Two cases are described in which immediate access to a medical information database and other Internet available resources altered physician decision making intraoperatively. The potential benefits, limitations, and difficulties encountered using such resources in the operating room are discussed.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.