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A Simulation Study of Noise Levels in the Obstetric Operating Room
Abstract Number: T-33
Abstract Type: Original Research
Noise in the operating room (OR) can distract the anesthesiologist and increase patient anxiety. (1) This is of particular importance during Cesarean delivery, when patients are awake and support people are present. High noise levels are associated with surgical site infections; (2) thus, decreasing noise levels is critical for safety. We performed this study to determine the intensity of sound created by common noises in the OR.
The SoundMeter app by Faber Acoustical was used to take measurements at the center of an empty obstetric OR. (3) Each session was measured for 10 seconds and A-weighted, which takes into account the logarithmic scale with which the human ear interprets changes in loudness. The average and maximum A-weighted decibel (dBA) levels were determined.
Ten sessions were recorded with these noise sources: baseline; 1, 2, and 3 suctions; 3 suctions and pulse oximeter at 60% or 100% volume; suctions and pulse oximeter with crinkling of glove paper; suctions and pulse oximeter with two people talking; suctions and pulse oximeter with two people talking and crinkling of glove paper simultaneously; suctions and pulse oximeter with throwing sharps away. Baseline dBA level was 54.3. The loudest reading occurred with 3 suctions, pulse oximeter at 100%, people talking, and crinkling of paper simultaneously, with an average 81.6 dBA.
The sensation of loudness is not proportional to the decibel level but is a logarithmic function, such that an increase of 10 dBA is perceived as twice as loud, an increase of 20 dBA is perceived as four times as loud, and so forth. Compared to a library (30 dBA), the OR baseline dBA level was 54.3 (perceived as 5.4x louder than the library) due to background humming noises. The maximum sound intensity observed in this study was 85.1 dBA, which is perceived as 8.5x louder than baseline. Noise is distracting to both patients and clinicians, and can lead to increased complications. Awareness of this issue is critical to a multidisciplinary effort to maintain a culture of quiet and safety in the obstetric OR.
1. Broom et al. Critical phase distractions in anaesthesia and the sterile cockpit concept. Anaesthesia 2011;66(3).
2. Dholakia et al. The association of noise and surgical-site infection in day-case hernia repairs. Surgery 2015;157(6).
3. Kardous et al. Evaluation of smartphone sound measurement applications. J Acoust Soc Am 2014;135(4).