Chowdhury Raisa, Orishchak Ostap, Mascarella Marco A, Aldriweesh Bshair, Alnoury Mohammed K, Bousquet-Dion Guillaume, Yeung Jeffrey, Nguyen Lily Ha-Nam P
Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC H4A 3J1, Canada.
Clin Pract. 2025 Jan 6;15(1):13. doi: 10.3390/clinpract15010013.
Emergency airway management is a critical skill for healthcare professionals, particularly in life-threatening situations like "cannot intubate, cannot oxygenate" (CICO) scenarios. Errors and delays in airway management can lead to adverse outcomes, including hypoxia and death. Cognitive aids, such as checklists and algorithms, have been proposed as tools to improve decision-making, procedural competency, and non-technical skills in these high-stakes environments. This systematic review aims to evaluate the effectiveness of cognitive aids in enhancing emergency airway management skills among health professionals and trainees. A systematic search of MEDLINE, Embase, CINAHL, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov was conducted from February to March 2024. Studies examining the use of cognitive aids, such as the Vortex method, the ASA difficult airway algorithm, and visual airway aids, in emergency airway scenarios were included. Outcomes assessed included decision-making speed, procedural success rates, and non-technical skills. Data were extracted using standardized protocols, and the quality of included studies was appraised. Five studies met inclusion criteria, encompassing randomized controlled trials, controlled studies, and mixed-methods research. Cognitive aids improved decision-making times (reduced by 44.6 s), increased procedural success rates, and enhanced non-technical skills such as teamwork and crisis management. Participants reported reduced anxiety and improved confidence levels (self-efficacy scores increased by 1.9 points). The Vortex method and visual cognitive aids demonstrated particular effectiveness in simulated scenarios. Cognitive aids significantly enhance emergency airway management skills, improving performance, reducing errors, and increasing provider confidence. Integrating cognitive aids into training programs has the potential to improve patient safety and outcomes. Further research is needed to validate these findings in clinical settings and optimize cognitive aid design and implementation.
紧急气道管理是医疗保健专业人员的一项关键技能，尤其是在诸如“无法插管、无法给氧”（CICO）等危及生命的情况下。气道管理中的错误和延误可能导致不良后果，包括缺氧和死亡。认知辅助工具，如检查表和算法，已被提议作为在这些高风险环境中改善决策、程序能力和非技术技能的工具。本系统评价旨在评估认知辅助工具在提高卫生专业人员和学员紧急气道管理技能方面的有效性。2024年2月至3月，对MEDLINE、Embase、CINAHL、Cochrane图书馆、Scopus、科学网和ClinicalTrials.gov进行了系统检索。纳入了在紧急气道场景中研究使用认知辅助工具的研究，如Vortex方法、美国麻醉医师协会困难气道算法和可视气道辅助工具。评估的结果包括决策速度、程序成功率和非技术技能。使用标准化方案提取数据，并对纳入研究的质量进行评估。五项研究符合纳入标准，包括随机对照试验、对照研究和混合方法研究。认知辅助工具缩短了决策时间（减少了44.6秒），提高了程序成功率，并增强了团队合作和危机管理等非技术技能。参与者报告焦虑减轻，信心水平提高（自我效能得分提高了1.9分）。Vortex方法和可视认知辅助工具在模拟场景中显示出特别的有效性。认知辅助工具显著提高了紧急气道管理技能，改善了表现，减少了错误，并增强了提供者的信心。将认知辅助工具纳入培训计划有可能提高患者安全和治疗效果。需要进一步研究以在临床环境中验证这些发现，并优化认知辅助工具的设计和实施。
