Contraindications are important to note

When I was preparing to be a flu vaccinator during a pre-med internship, part of my training involved asking patients the right preliminary questions before I administered the flu vaccine.

These questions had the purpose of ascertaining if the individual shouldn’t be given the shot.

In medicine, a contraindication is something that tells a clinician that the drug or treatment should not be utilized for a particular patient.

For example, if someone has had a previous allergic reaction to the flu vaccine or if they have a history of Guillain-Barré Syndrome, these are red flags. According to my clinic’s procedures, these contraindications meant that the patient could not receive the vaccine.

Feeling sick can also be a sign that you should wait

If a patient was already feeling sick, we were instructed to ask them to return after they felt better. This is not because the flu vaccine gives you the active virus. (I wonder if that’s worth repeating for the anti-vaxxers in the back.)

The flu vaccine simply works to activate your immunity against the flu virus. By injecting you with deactivated viral components, the vaccine helps you build a customized immune response that can at least partially help you fight infection from the real strain that particular year.

In a sick person, the immune response had already been activated to fight the illness. Since the vaccine will further activate the patient’s immune response, it’s better to wait, if possible, in order to avoid overwhelming the body.

On a larger scale, failing to complete simple tasks is causing thousands of deaths.

I’m so grateful I ran through the verbal checklist with her

Once, a polished, professional young woman walked into my office to receive the vaccine. I ran through the requisite questions with her, but I will admit that I had preconceived notions about her.

She looked healthy.

When I asked her how she felt, she paused. She then replied, “I do feel a little sick.”

She didn’t look sick. Still, her answer put me on alert. After hesitating more, she added, “And I should let you know that I am HIV positive.”

An autoimmune disease in conjunction with a present bacterial or viral infection is a critical contraindication to the flu shot. I was speechless for a moment because my biases had prevented me from keeping an open mind about her possible physiological state.

We also weren’t instructed to check these kinds of contraindications, although we should have been.

I immediately consulted with the rest of the care team, but I knew the answer would be that she absolutely shouldn’t have the shot administered that day.

Had I not asked her the perfunctory question of “Are you feeling alright today?” maybe she wouldn’t have shared any of this with me. Perhaps she would have taken it upon herself to assume the risk of the flu shot because she didn’t know how tremendous that risk could be.

This is just my anecdotal experience, but our healthcare system is rife with clinical mistakes because we have not yet fully addressed our own cognitive limitations.

On a larger scale, failing to complete simple tasks is causing thousands of deaths.

Here’s another case that made headlines due to its gruesome nature

Frances Barnes was an eighty-year-old grandmother whose leg was amputated due to a preventable infection.

The cause: hospital staff did not remove her compression stockings every 30 minutes, as specified by her doctor.

Kaiser recently posted a sobering healthcare statistic:

“In 2010, the federal government estimated that faulty medical care contributed to the death of about 15,000 Medicare patients per month.”

Many of these deaths could have been prevented by implementing and enforcing a mandatory checklist.

Cognitive load should be an acknowledged limitation

At the end of the day, we are people being stretched in several directions. At a certain point, our cognitive load becomes too great, and things start slipping.

This results in unintentional yet tragic outcomes, which are avoidable.

If a checklist can prevent loss of human life, then isn’t it just as important as other types of preventive medicine?

Shouldn’t we take it that seriously?