EC Paediatrics

The tunnel effect corresponds to a cognitive bias that leads to fixation on an expected result, which favors the occurrence of errors by preventing consideration of all the elements available. Cognitive biases, of which the tunnel effect is a part, are the consequence of the limited capacities of humans under certain conditions to take into account and process all the information potentially available.

Study concerning two clinical situations that occurred in September 2022, hospitalized in the pediatric intensive care unit of the EL Harouchi hospital in Casablanca, and having the objective of illustrating the tunnel effect in the diagnostic approach within our service.

The first case was of a 3-year-old girl with a history of two asthmatic brothers, admitted to the emergency room for febrile respiratory distress, and treated in the intensive care unit as severe acute asthma. The evolution was marked by the persistence of the respiratory signs, of which a thoracic scanner was carried out objectifying the presence of a foreign body intra bronchial lobar left superior, the patient had a bronchoscopy with extraction of the foreign body, and the clinical evolution was favorable, allowing her to return home.

2^nd case was a 5-year-old boy, with a personal history of two episodes of wheezing dyspnea, presented to the emergency room for respiratory distress with suspicion of inhalation of a foreign body. The mother reported a notion of taking peanuts 2 days before. The patient benefited from a bronchoscopy which was normal, 10 min after the gesture, he worsened on the respiratory level, of which he was sent to intensive care for additional care. Treated as a severe acute asthma attack, the evolution was favorable.

In clinical practice, it is important to be aware of the existence of these cognitive biases and of ways to reduce them.

Keywords: Tunnel; Effect; Children; Medicine; Errors

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