Free Emergency Manual Books Improve Actual Clinical Use During Crisis in China

Abstract

Introduction Emergency manuals (EM) are widely implemented and effective tools for anesthesiologists and perioperative teams to manage patients during critical events. Team simulation studies have shown that the use of training aids and checklists decreases human error. Previous research has examined the use of EM at hospitals in the United States, but few studies have explored its impact in an international setting. In this paper, we conduct a nationwide survey in China to assess the implementation and effectiveness of EM in clinical settings. Methods Based on the known benefits of using these training aids, we hypothesize that introducing EM will improve team response and reduce errors during crisis management. Copies of the translated Stanford University Operating Room Emergency Handbook were distributed free of charge to hospital anesthesiology departments across China. A survey was then sent out to members of the New Youth Anesthesia Forum, a social networking group of over 100,000 anesthesiologists. Results Respondents (n = 818) were separated based on whether or not they received the free EM (yes = 410; no = 408). Our study found that groups who received the manuals demonstrated significantly higher levels of self-review, group study, simulation training participation, and usage during critical events than groups that did not receive the free books (respectively; p < 0.001). Conclusions These findings strengthen prior evidence suggesting that implementing EM can contribute to the effective management of acute events in a hospital and preoperative setting. Overall, EM can minimize preventable patient risk and benefit anesthesiologists in their clinical practice. These findings indicate that free books can enhance the implementation of emergency manual and actual emergency manual use during critical events.

Use of Emergency Manuals to Treat Delayed Emergence After Robotic-Assisted Cholecystectomy

“…Since studies have shown that humans lack optimal recall of long-term memory during stressful situations, cognitive aids such as EMs can be used to ensure that best practices are consistently being delivered [ 5 - 8 ]. Although EMs have demonstrated benefit in simulation and clinical settings, it is important to train clinicians in the use of the EMs on content, format and location [ 6 , 12 ].…”

“…Given the difficulty in determining the true incidence of delayed emergence and its multiple causes, prior preparation and readiness are vital when these situations arise. Studies have shown that humans in general do not optimally retrieve details from long-term memory during stressful situations, but operating room teams deliver best practices more often and efficiently when using cognitive aids [ 5 - 8 ]. Operating room emergency manuals (EMs) contain cognitive aids with evidence-based guidelines on the management of specific intraoperative critical events [ 7 ].…”

Use of Emergency Manuals to Treat Intraoperative Supraventricular Tachycardia and Hypotension During Exploratory Laparotomy

“…EMs have been shown to improve the clinical outcome of critical events and reduce the incidence of missing key steps during crisis management [6,14]. EMs also increase teamwork, efficiency, collaboration, and confidence [9][10][11][14][15][16]. In the patient's case, the use of an EM directly improved patient care and avoided any adverse event that may have occurred with selection of a different…”

“…Operating room emergency manuals (EMs) are cognitive aids that contain current, medically established guidelines on the management of specific perioperative critical events [8]. The use of operating room EMs has been shown to reduce medical error and maximize productivity by allowing healthcare providers, especially anesthesia professionals, to respond more confidently and collaboratively to critical events [9][10][11].…”

Airway management in hospital. Methodological recommendations of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” (third edition)

“…Метаанализ 2019 г., проведенный Simmons W.R., продемонстрировал важную роль применения экстренных алгоритмов в операционных в обеспечении безопасности пациентов [249]. По данным анализа применения алгоритмов действий в критических ситуациях (распространялись бесплатно в виде книг по стационарам) в Китае, получены доказательства эффективности в виде снижения частоты предотвратимых осложнений и улучшения действий специалистов в случае их развития [250][251].…”