The effects of a displayed cognitive aid on non-technical skills in a simulated 'can't intubate, can't oxygenate' crisis

Anaesthesia. 2014 Jul;69(7):669-77. doi: 10.1111/anae.12601.

Abstract

Guidelines outlining recommended actions are difficult to implement in the stressful, time-pressured situation of an airway emergency. Cognitive aids such as posters and algorithms improve performance during some anaesthetic emergencies; however, their effects on team behaviours have not been determined. In this study, 64 participants were randomly assigned into control (no cognitive aid) and intervention (cognitive aid provided) groups before a simulated 'can't intubate, can't oxygenate' scenario. Video analysis was undertaken of the non-technical skills and technical performance during the scenarios. All categories had higher Anaesthetists' Non-Technical Skills (ANTS) scores when a cognitive aid was supplied (mean (SD) total ANTS score 10.4 (3.1) vs. 13.2 (2.4), p < 0.001). The number of times the cognitive aid was used was associated with higher ANTS scores (ρ = 0.383, p = 0.002). A trend towards the establishment of an infraglottic airway within 3 min was also noted (control group 55.3% vs. intervention 76.9%, p = 0.076). Non-technical skills are improved when a cognitive aid is present during airway emergencies.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Airway Management / methods*
  • Airway Obstruction / therapy*
  • Analysis of Variance
  • Clinical Competence / statistics & numerical data*
  • Emergency Medical Services / methods*
  • Humans
  • Inservice Training / methods*
  • Intubation, Intratracheal
  • Manikins
  • Posters as Topic*
  • Prospective Studies