Rineau Emmanuel, Collard Anna, Jean Lorine, Guérin Sarah, Maunoury Louise, Martin Ludovic, Lasocki Sigismond, Léger Maxime
All'Sims Center for Medical Simulation, Health Faculty and University Hospital of Angers, 49100 Angers, France.
Department of Anesthesia and Critical Care, University Hospital of Angers, 49100 Angers, France.
Healthcare (Basel). 2021 Nov 27;9(12):1646. doi: 10.3390/healthcare9121646.
When anesthesia checklists and preparations are performed urgently, omissions may occur and be deleterious to the patient. The aim of this study was to evaluate in simulation the interest of a cognitive aid to effectively prepare an anesthetic room for an emergency. In a prospective single-center simulation-based study, 32 anesthesia residents had to prepare an anesthetic room in an emergency scenario, without cognitive aid in the first phase. Three months later (phase 2), they were randomly assigned to receive a cognitive aid (aid group) or no additional aid (control) and were involved in the same scenario. The primary outcome was the validation rate of each essential item in the first 5 min in phase 2. Eight items were significantly more frequently completed in the first 5 min in the aid group in phase 2 (vs. phase 1), compared with two only in the control group. However, there were no significant differences in the overall number of completed items between the two groups, as both groups completed significantly more items in phase 2, either in the first 5 min (19 (14-23) vs. 13 (9-15) in phase 1 for all residents, < 0.001) or without time limit. Preparation times were reduced in phase 2 in both groups. In conclusion, the use of a cognitive aid allowed anesthesia residents to complete some safety items of a simulated urgent anesthesia preparation more frequently. In addition, despite daily clinical experience, a single simulation session improved anesthesia preparation and reduced the preparation time with or without cognitive aid.
当紧急进行麻醉清单检查和准备工作时，可能会出现遗漏，这对患者有害。本研究的目的是在模拟中评估一种认知辅助工具对于有效为紧急情况准备麻醉室的作用。在一项前瞻性单中心基于模拟的研究中，32名麻醉住院医师必须在紧急情况下准备麻醉室，第一阶段没有认知辅助工具。三个月后（第二阶段），他们被随机分配接受认知辅助工具（辅助组）或不接受额外辅助工具（对照组），并参与相同的场景。主要结局是第二阶段前5分钟内每个关键项目的验证率。与对照组仅两项相比，辅助组在第二阶段的前5分钟内（与第一阶段相比）有八项关键项目的完成频率显著更高。然而，两组之间完成项目的总数没有显著差异，因为两组在第二阶段完成的项目都显著更多，无论是在前5分钟（所有住院医师在第一阶段为13（9 - 15）项，第二阶段为19（14 - 23）项，<0.001）还是没有时间限制的情况下。两组在第二阶段的准备时间都减少了。总之，使用认知辅助工具使麻醉住院医师更频繁地完成模拟紧急麻醉准备的一些安全项目。此外，尽管有日常临床经验，但单次模拟训练改善了麻醉准备工作，并且无论有无认知辅助工具都减少了准备时间。
