ORIGINAL ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 1  |  Page : 28-32

Variability in risk tolerance and adherence to guidelines in “go or no-go” decisions among anesthetists in Saudi Arabia


1 Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
2 Consultant of Anesthesiology, Department of Anesthesia and Critical Care, King Abdulaziz University, Jeddah, Saudi Arabia
3 Consultant of Anesthesiology, Department of Anesthesia and Critical Care; General Supervisor, Clinical Skills and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia

Correspondence Address:
Dr. Abdulaziz M Boker
Department of Anaesthesiology and Critical Care, General Supervisor of Clinical Skills and Simulation Center, King Abdulaziz University Hospital, P. O. Box: 80215, Jeddah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_281_19

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Background: Anesthetists deal with many situations where they decide whether proceeding with anesthesia is safe or not. These are termed “go or no-go” decisions. Although guidelines have been developed to ensure safe anesthesia, many factors affect anesthetists' decision in practice. Therefore, we aimed to assess the variability in risk tolerance when making “go or no-go” decisions among anesthetists in Saudi Arabia. Materials and Method: A questionnaire-based study that included anesthetists practicing in Saudi Arabia from 1--14th October 2017 was conducted. The questionnaire presented 11 clinical scenarios that involved deviation from guidelines, followed by four questions where the participants were asked to decide whether they would proceed with administering anesthesia, write a comment explaining their decision, to predict whether a colleague would make the same decision, and if they had a previous similar experience. Results: A total of 124 anesthetists responded, of which 56.5% were consultants. There was no absolute consensus over the decision to proceed in any scenario. Most of the respondents who would proceed (67.35%) expected a colleague to make the same decision. Anesthetists who encountered a previous similar experience were more likely to proceed (P = 0.000). There was no significant difference among the respondents' decisions according to years of experience (P = 0.121). Analysis of the comments showed that procedure urgency and presence of alternatives to deficient resources were the most frequent factors that dictated anesthetists' decision. Conclusion: There is a wide variation in risk tolerance among anesthetists. Further simulation-based studies are needed to identify and address factors that affect anesthetists' decisions.


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