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Colin F. Mackenzie

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Publications by Colin F. Mackenzie (bibliography)

1995

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Harper, Ben D., Mackenzie, Colin F. and Norman, Kent L. (1995): Quantitative Measures in the Ergonomic Examination of the Trauma Resuscitation Units Anesthesia Workspace. In: Proceedings of the Human Factors and Ergonomics Society 39th Annual Meeting 1995. pp. 723-727.

“This study examines the anesthesia care providers' workspace in the trauma resuscitation bay of the shock/trauma unit of a university hospital. Intubation, the placement of a tube into the trachea to facilitate ventilation, is performed in critical cases brought to the trauma resuscitation unit. This analysis focuses on the task of intubation and explores the utility of a measure of equipment location efficiency called Workspace Appropriateness.”

1993

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Mackenzie, Colin F., Horst, Richard L. and Mahaffey, David L. (1993): Group Decision-Making during Trauma Patient Resuscitation and Anesthesia. In: Proceedings of the Human Factors and Ergonomics Society 37th Annual Meeting 1993. pp. 372-376.

“We examined decision-making in the real-world environment of trauma patient resuscitation and anesthesia in a Level One Trauma Center. The present paper focuses on the risk factors in the trauma treatment environment that can lead to errors or misjudgments, and strategies that may be helpful in reducing these risks. Video and audio recordings were made of a number of trauma cases involving tracheal incubation, including both emergency intubations performed during resuscitation and "elective" intubations prior to surgery. Post-treatment questionnaires completed by anesthesia personnel suggested that their perceived misjudgments were primarily procedural errors caused by lack of preparation for low probability events, inadequate monitoring of available indices, or carelessness. However, video analyses of a subset of the cases by a non-participant anesthesiologist, in conjunction with examination of patient management records, not only confirmed the occurrence of such errors but also identified instances of knowledge-based errors, which caused subsequent cascades of adverse events. Video analysis also documented the shortcuts that are characteristic of emergency intubations. The post-treatment questionnaires also suggested an association between team interactions and anesthesiologist performance. To follow up on this, we transcribed and categorized verbal communications for several minutes before, during, and after incubation in a subset of cases. This analysis indicated that during emergency intubations not only was more information communicated than during elective intubations, but that there were increases specifically in the incidence of directives, comments conveying plans or strategies, and comments both seeking and offering needed information. The discussion presents a number of strategies that emerged from the present analyses for reducing the risk factors involved in trauma treatment decision-making.”

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