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

Marshall, Stuart; Mehra, Rishi

doi:10.1111/anae.12601

Cited by 100 publications

(91 citation statements)

References 23 publications

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“…Their use in emergencies would seem to be ideal as they can help the prompt application of complex guidelines when there are time pressures and an excess of information for the team to manage [29,30]. Designs of cognitive aids must be mindful of the context in which they are used.…”

Section: The Das Guidelines As a Cognitive Prosthesismentioning

confidence: 99%

Radical evolution: the 2015 Difficult Airway Society guidelines for managing unanticipated difficult or failed tracheal intubation

Marshall

Pandit

2015

Anaesthesia

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Section: The Das Guidelines As a Cognitive Prosthesismentioning

confidence: 99%

Radical evolution: the 2015 Difficult Airway Society guidelines for managing unanticipated difficult or failed tracheal intubation

Marshall

Pandit

2015

Anaesthesia

Self Cite

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“…Complex visual aids such as the ASA algorithm may be more useful for teaching, while graphic cognitive aids like the Vortex or the Swedish traffic light concept may be more helpful for decision‐making under stress. Not surprisingly, there is a lack of outcome studies, although some cognitive aids have been evaluated in simulation settings . More research is needed to understand what really works for both teaching pediatric anesthesia and when unexpected airway problems arise in clinical situations.…”

Section: Resultsmentioning

confidence: 99%

Visual aids for pediatric airway management

Frykholm

2020

Pediatric Anesthesia

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Four basic types of visual aids are used for teaching airway management and decision‐making in simulated as well as in real clinical situations: universal algorithms, sets of limited algorithms, concept‐based cognitive aids, and checklists. The first three may represent an evolution in the understanding of the role of human error in both successful and failed airway management. Complex visual aids such as the American Society of Anesthesiology difficult airway algorithm may be more useful for teaching, while graphic cognitive aids like the Vortex may be more helpful for decision‐making under stress. Not surprisingly, there is a lack of outcome studies, although some cognitive aids have been evaluated in simulation settings.

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“…The use of checklists and cognitive aids can improve standardisation, teamwork and overall performance in operating theatres and during crisis situations [43,[176][177][178][179][180][181], and several have been described for use in general [45,182] and obstetric anaesthesia [44,183,184].…”

Section: Teachingmentioning

confidence: 99%

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

Mushambi¹,

Kinsella²,

Popat³

et al. 2016

Obstetric Anesthesia Digest

114

221

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SummaryThe Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably secondgeneration) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training.

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

Cited by 100 publications

References 23 publications

Radical evolution: the 2015 Difficult Airway Society guidelines for managing unanticipated difficult or failed tracheal intubation

Radical evolution: the 2015 Difficult Airway Society guidelines for managing unanticipated difficult or failed tracheal intubation

Visual aids for pediatric airway management

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

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