University of Queensland Cognitive Engineering Research Group, Brisbane, Queensland, Australia; Monash University Academic Board of Anaesthesia and Perioperative Medicine, Melbourne, Victoria, Australia; Monash Simulation, Monash Health, Melbourne, Victoria, Australia.
Anaesthesia. 2014 Jul;69(7):669-77. doi: 10.1111/anae.12601.
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.
在气道紧急情况下，概述推荐行动的指南很难实施，因为这是一个充满压力和时间压力的情况。认知辅助工具，如海报和算法，可以在某些麻醉紧急情况下提高绩效；然而，它们对团队行为的影响尚未确定。在这项研究中，64 名参与者在模拟的“无法插管，无法给氧”场景之前被随机分配到对照组（无认知辅助）和干预组（提供认知辅助）。对场景中的非技术技能和技术表现进行了视频分析。当提供认知辅助时，所有类别都有更高的麻醉师非技术技能（ANTS）评分（平均（SD）总 ANTS 评分 10.4（3.1）比 13.2（2.4），p<0.001）。使用认知辅助的次数与更高的 ANTS 评分相关（ρ=0.383，p=0.002）。还注意到在 3 分钟内建立声门下气道的趋势（对照组为 55.3%，干预组为 76.9%，p=0.076）。在气道紧急情况下，当存在认知辅助时，非技术技能会得到提高。
