Adapting Use of The “Sterile Cockpit Rule” in Radiology

The “Sterile Cockpit Rule” is a Federal Aviation Administration (FAA) regulation that was implemented in 1981 after a series of accidents occurred when flight crews became distracted from unnecessary conversations during critical flight duties during takeoffs and landings. One such accident occurred in 1974 in Charlotte, NC, which resulted in 71 out of 82 lives being lost due to a pilot’s discussion on politics rather than focusing on the upcoming landing.

In another accident that occurred at Dallas-Fort Worth, a crash occurred that was linked to aircraft flaps not being down during takeoff. Fourteen lives were lost in this accident which was linked to nonessential conversation during the checklist procedure.

This FAA regulation states that flight crews are prohibited from activities or nonpertinent conversation during the critical phases of flight which encompasses taxi, takeoff, landing, and operations below 10,000 feet mean sea level. This regulation was recently expanded by the FAA to prohibit the use of personal tablets, smartphones, and laptops for personal use during the entire flight.

The health care industry has become a very complicated field with the same deadly opportunities for error due to distractions. Are there distractions while radiology nurses are drawing medications or taking medications out of drug dispensing systems, during the time out process, site marking for a biopsy or checking for medication allergies? Wrong site procedures and retained foreign objects continue to be an issue reported to the Joint Commission and state agencies. The Joint Commission cites inattention as a contributing factor to wrong site procedures.

Radiology is a minefield of opportunities for medical errors and the Sterile Cockpit philosophy can help improve patient safety when implemented in appropriate circumstances. This has been proven by the FAA through implementation of this regulation which has contributed to aviation safety by focusing on eliminating distractions during critical times of takeoffs and landings.

I recently e-mailed an article to my radiology staff on the FAA’s Sterile Cockpit regulation asking them for suggestions on circumstances other than those previously mentioned that this concept can be used and for engineering ideas on processes to implement it.