Lessons from the battlefield: Human factors in defence anaesthesia

Anaesthetists in the Defence Medical Services spend most of their clinical time in the National Health Service and deploy on military operations every 6–18 months. The deployed operational environment has a number of key differences particularly as there is more severe trauma than an average UK hospital and injury patterns are mainly due to blast or ballistics. Equipment may also be unfamiliar and there is an expectation to be conversant with specific standard operating procedures. Anaesthetists must be ready to arrive and work in an established team and effective non-technical skills (or human factors) are important to ensure success. This article looks at some of the ways that the Department of Military Anaesthesia, Pain and Critical Care prepares Defence Anaesthetists to work in the deployed environment and focuses on the importance of human factors. This includes current work in the field hospital in Afghanistan and also preparing to work for the Royal Air Force and Royal Navy. We highlight the importance of human factors with reference to the type of case mix seen in the field hospital. We also detail the current pre-deployment training package, which employs multiple educational tools including high-fidelity simulation.