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. 2021 Nov 27;9(12):1646.
doi: 10.3390/healthcare9121646.

Cognitive Aid for Anesthetic Preparation in An Emergency Situation: A Simulation-Based Study

Emmanuel Rineau  1   2 , Anna Collard  1   2 , Lorine Jean  1   2 , Sarah Guérin  1   2 , Louise Maunoury  1   2 , Ludovic Martin  1   3 , Sigismond Lasocki  1   2 , Maxime Léger  1   2
Affiliations

Cognitive Aid for Anesthetic Preparation in An Emergency Situation: A Simulation-Based Study

Emmanuel Rineau et al. Healthcare (Basel). .

Abstract

When anesthesia checklists and preparations are performed urgently, omissions may occur and be deleterious to the patient. The aim of this study was to evaluate in simulation the interest of a cognitive aid to effectively prepare an anesthetic room for an emergency. In a prospective single-center simulation-based study, 32 anesthesia residents had to prepare an anesthetic room in an emergency scenario, without cognitive aid in the first phase. Three months later (phase 2), they were randomly assigned to receive a cognitive aid (aid group) or no additional aid (control) and were involved in the same scenario. The primary outcome was the validation rate of each essential item in the first 5 min in phase 2. Eight items were significantly more frequently completed in the first 5 min in the aid group in phase 2 (vs. phase 1), compared with two only in the control group. However, there were no significant differences in the overall number of completed items between the two groups, as both groups completed significantly more items in phase 2, either in the first 5 min (19 (14-23) vs. 13 (9-15) in phase 1 for all residents, p < 0.001) or without time limit. Preparation times were reduced in phase 2 in both groups. In conclusion, the use of a cognitive aid allowed anesthesia residents to complete some safety items of a simulated urgent anesthesia preparation more frequently. In addition, despite daily clinical experience, a single simulation session improved anesthesia preparation and reduced the preparation time with or without cognitive aid.

Keywords: anesthesia; checklist; cognitive aid; emergency; patient safety; simulation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
English translation of the cognitive aid given to the anesthesia residents. ECG, electrocardiogram; ETT, endotracheal tube; APL, adjustable pressure-limiting; NMB, neuromuscular blocker.
Figure 2
Figure 2
Percentages of residents who validated each required item in the first 5 min in control (blue bars) and aid (yellow bars) groups in phase 1 (plain filling) and phase 2 (hatched filling). *, p < 0.05 using a paired comparison with phase 1. p < 0.05 between the control group and the aid group in phase 2.
Figure 3
Figure 3
Durations of the anesthetic preparation by residents of control group (blue boxes) and aid group (yellow boxes), in phase 1 (plain filling) and phase 2 (hatched filling). Residents in the aid group had a cognitive aid in phase 2, but not in phase 1. n = 16 in each group. *, significant difference with the same group in phase 1.
See this image and copyright information in PMC

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