• Stuart D Marshall, Cameron Rush, Lucy Elliott, Harry Wadman, Jane Dang, Ashley St John, and Fiona E Kelly.
• Peninsula Health - Frankston Hospital, Frankston, VIC, Australia; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: marshall.s@unimelb.edu.au.
• Br J Anaesth. 2024 Jul 1; 133 (1): 118124118-124.

BackgroundThe 7th National Audit Project of the Royal College of Anaesthetists (NAP7) recommended that an emergency call system be immediately accessible in all anaesthesia locations. It is essential that all theatre team members can rapidly call for help to reduce the risk of patient harm. However, the ability of staff to activate this system in a timely manner can be affected by cluttered or unfamiliar environments and cognitive overload. One proposed strategy to enable rapid identification and activation of emergency call systems is to install a red vertical painted stripe on the wall from the ceiling to the activation button. We investigated the effect of introducing this vertical red line on activation times in operating theatres in the UK and Australia.MethodsOperating theatre team members, including anaesthetists, surgeons, anaesthetic nurses, surgical and theatre nurses, operating theatre practitioners, and technicians, were approached without prior warning and asked to simulate activation of an emergency call. Vertical red lines were installed, and data collection repeated in the same operating theatres 4-12 months later.ResultsAfter installation of vertical red lines, the proportion of activations taking >10 s decreased from 31.9% (30/94) to 13.6% (17/125, P=0.001), and >20 s decreased from 19.1% (18/94) to 4.8% (6/125, P<0.001). The longest duration pre-installation was 120 s, and post-installation 35 s.ConclusionsThis simple, safe, and inexpensive design intervention should be considered as a design standard in all operating theatres to minimise delays in calling for help.Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.

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