Indian Journal of Surgery, Vol. 67, No. 1, January-February, 2005, pp. 53-54
Mobile phone and the surgeon - Is there a controversy?
Department of Surgery, Sri Ramachandra Medical College and Research Institute, Deemed University, Chennai - 600 116
Code Number: is05012
AbstractMobile phones have become an inseparable and trusted companion of the surgeons. Recently, West Bengal Government circular barred the use of mobile phones by surgeons inside the operation theatre. Although the use of a mobile phone is restricted in an operation theatre and intensive care units due to its interference with medical electrical equipment, for surgeons it is the most valuable friend at the time of crisis and in critical situations.
Keywords: Mobile phones, electromagnetic interference, short message service
Mobile phones (cell phones) are an established method of communication in hospitals and are commonly used with many benefits to patient care. It is a constant companion for all doctors and for surgeons also. Alarmed at the flood of complaints against doctors busy talking on the mobile phone in operation theatres or while seeing patients, the West Bengal government has recently banned their use in operation theatres and intensive care units. It is now the issue to ponder whether the mobile phone is really hampering the surgeons′ work and their concentration during the procedures.
ADVERSE EFFECTS OF MOBILE PHONES
Mobile phones are banned in a few hospitals in the UK, as they are considered potentially hazardous in medical environments. Although there are various reports like increased risk of vehicular accidents, leukaemia, sleep disturbances and brain tumours in mobile users, the most harmful effect in hospitals is its interference with medical electrical equipment. It is of concern that at least 4% of devices tested in any study were susceptible to clinically relevant electromagnetic interference. All studies recommend some type of restriction of mobile phone use in hospitals, usually restricting to minimum 1 meter away from equipment. It is also accepted that the noise from mobile phones ringing in the ward disturbs staff and patients. Similarly, ringing of mobile phones during consultation also disturbs and irritates the patient.
′CLINICAL′ USES OF MOBILE PHONES
For a surgeon, mobile phones have become a partner in his clinical practice. Short message service (SMS) has been recognized as a very useful tool for surgeons which allows them to seek help, suggestions and also discuss interesting cases with their colleagues. In a study from Australia, mobile phone photo-messaging was used for 27 cases of hand trauma for correspondence between the registrar and the consultant in the emergency department over a 2-month period. The study recommended the use of mobile phone photo messaging into the clinical practice. Therefore, there is always a growing and legitimate communication need of the patient and attendants with the concerned surgeon especially at the time of crisis and the mobile phone is the only source in that situation.
SURGEONS′ MOBILE PHONES IN THE OPERATION THEATRE
The often reported criticism that ′surgeon talking on the mobile phone in the middle of a operation in the theatre′ affects his concentration and surgical skill may be an overreaction. In a study from Hong Kong on the effect of mobile phones on human attention in 78 university students, it was seen that participants in the experimental group performed better on one of the three measures of attention only after they had been exposed to the electromagnetic field emitted by the mobile phone for some time than the control group (non-mobile phone users). The study suggested that exposure to the electromagnetic field emitted by mobile phones may have a mild facilitating effect on attention functions and also on cognitive processing. Another study from the UK, to investigate the effects of acute mobile phone exposure on a range of tasks which tapped capacity and processing speed within the attentional system, it was seen that performance was facilitated following mobile phone exposure and no deficits were evident. Thus, the ethical and rational use of a mobile phone inside the operation theatre should be justified as every surgeon needs to be well informed about his patients′ pre and postoperative condition at all times, even when he is operating on a critical patient. In case of an emergency, he can seek urgent help from his superiors and colleagues. He can also call for an opinion from the biomedical or electrical staff in case of some mechanical or instrument failure, in the middle of the surgery. His mobile can also be used to reschedule / cancel his appointments in case the surgery gets delayed. For personal purposes, a surgeon′s family member can trace him whenever necessary through a mobile. Overall, the ability to directly contact and speak to an appropriate professional member of a team (due to the immense memory of a mobile phone directory) instantaneously is very important in the multidisciplinary care for many sick and critical patients. This often obviates the prolonged and frustrating loops through painfully slow hospital intercoms and usually defunct paging system. However, the fear that sudden adverse news on a surgeon′s mobile may affect the ongoing surgery may sound rational but will require concrete evidence before enforcing a ban on mobiles in the operating theatres. In the UK, the Medicines and Healthcare Product Regulatory Agency (MHRA) recommends that ′a balanced approach is necessary to ensure that the benefits of mobile wireless technology can be made to all organizations′. To conclude, if mobile phones are used sensibly, the benefits to patient care may far outweigh the limited risk of interfering with equipment, particularly in an emergency situation.
Copyright 2005 - Indian Journal of Surgery