Behrens Vicente, Dudaryk Roman, Nedeff Nicholas, Tobin Joshua M, Varon Albert J
From the *Division of Trauma Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida; †Division of Trauma Anesthesiology, Department of Anesthesiology, Keck School of Medicine at USC, Los Angeles, California; and ‡Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida.
Anesth Analg. 2016 May;122(5):1484-7. doi: 10.1213/ANE.0000000000001186.
Despite mixed results regarding the clinical utility of checklists, the anesthesia community is increasingly interested in advancing research around this important topic. Although several checklists have been developed to address routine perioperative care, few checklists in the anesthesia literature specifically target the management of trauma patients. We adapted a recently published "trauma and emergency checklist" for the initial phase of resuscitation and anesthesia of critically ill trauma patients into an applicable perioperative cognitive aid in the form of a pictogram that can be downloaded by the medical community. The Ryder Cognitive Aid Checklist for Trauma Anesthesia is a letter-sized, full-color document consisting of 2 pages and 5 sections. This cognitive aid describes the essential steps to be performed: before patient arrival to the hospital, on patient arrival to the hospital, during the initial assessment and management, during the resuscitation phase, and for postoperative care. A brief online survey is also presented to obtain feedback for improvement of this tool. The variability in utility of cognitive aids may be because of the specific clinical task being performed, the skill level of the individuals using the cognitive aid, overall quality of the cognitive aid, or organizational challenges. Once optimized, future research should be focused at ensuring successful implementation and customization of this tool.
尽管检查表的临床实用性结果不一,但麻醉学界对围绕这一重要主题推进研究的兴趣日益浓厚。虽然已经制定了几份检查表来处理围手术期常规护理,但麻醉文献中专门针对创伤患者管理的检查表却很少。我们将最近发表的一份“创伤与急救检查表”改编成适用于危重伤病员创伤患者复苏和麻醉初始阶段的围手术期认知辅助工具,采用了一种可供医学界下载的象形图形式。《莱德创伤麻醉认知辅助检查表》是一份信纸大小的全彩文件,共2页5个部分。这份认知辅助工具描述了需要执行的基本步骤:在患者抵达医院之前、患者抵达医院时、初始评估和管理期间、复苏阶段以及术后护理期间。还进行了一项简短的在线调查,以获取改进此工具的反馈。认知辅助工具效用的差异可能是由于所执行的特定临床任务、使用认知辅助工具的个体的技能水平、认知辅助工具的整体质量或组织方面的挑战。一旦优化,未来的研究应侧重于确保该工具的成功实施和定制。