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CARDIOVASCULAR ANESTHESIA

Use of Cognitive Aids in a Simulated Anesthetic Crisis

From the Patient Simulation Center of Innovation at VA Palo Alto Health Care System and the Department of Anesthesia, Stanford University School of Medicine, Stanford, California.

Address correspondence and reprint requests to T. Kyle Harrison, MD, Anesthesia Service, 112A VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304 USA. Address e-mail to kharriso{at}stanford.edu.

We evaluated empirically the extent to which the use of a cognitive aid during a high-fidelity simulation of a malignant hyperthermia (MH) event facilitated the correct and prompt treatment of MH. We reviewed the management of 48 simulated adult MH scenarios; 24 involving CA 1 and 24 involving CA 2 residents. In the CA 1 group, 19 of the 24 teams (79%) used a cognitive aid, but only 8 of the 19 teams used it frequently or extensively. In the CA 2 group, 18 of the 23 teams (78%) used a cognitive aid but only 6 of them used it frequently or extensively. The frequency of cognitive aid use correlated significantly with the MH treatment score for the CA 1 group (Spearman r = 0.59, P < 0.01) and CA 2 group (Spearman r = 0.68, P < 0.001). The teams that performed the best in treating MH used a cognitive aid extensively throughout the simulation. Although the effect was less pronounced in the more experienced CA 2 cohort, there was still a strong correlation between performance and cognitive aid use. We were able to show a strong correlation between the use of a cognitive aid and the correct treatment of MH.

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