The emotional impact of a death on the theatre table on the anaesthetist in South Africa

Abstract

Introduction: Perioperative deaths in developing countries are a common occurrence, thus an anaesthetist in South Africa is likely to experience at least one death on the table during his career. It affects the anaesthetist emotionally and can lead to a variety of disorders like anxiety, depression, substance abuse and most commonly post-traumatic stress disorder (PTSD). Certain interventions, like debriefings, have been proposed in order to mitigate the impact of a death on the table, but are not done regularly. The aim of this study was to determine the emotional impact that a death on the theatre table has on anaesthetists. We determined whether the anaesthetist was debriefed, had time off after the death and measured the prevalence of subsequent PTSD. Methods: The study followed a quantitative observational, cross-sectional design with convenient sampling using an online questionnaire. The Impact of Events Scale- Revised was used to measure the likelihood of PTSD. The study population was anaesthetists (consultants and registrars) registered with SASA who has experienced a death on the table. Results: A total of 1859 potential participants were contacted of which 453 responded, yielding a 24% response rate. The final analysis included 375 completed questionnaires. A total of 28.8% (CI 24.4%- 33.6%) had a probable diagnosis of PTSD. Age, years of experience and level of qualification did not affect the likelihood of developing PTSD. Only 15.5% of respondents were debriefed although 82.7% would have wanted a debriefing. Of the respondents with probable PTSD, 93% would have wanted debriefing, 85% would have liked time off and 82% felt the event influenced their work decisions. Correlating figures in those without PTSD was lower (78%, 61% and 67% respectively). Conclusion: The prevalence of PTSD following a death on the table was high and debriefings were not done in most cases. The authors recommend the development of workplace protocols to help an anaesthetist deal with a death on the table.