Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load
Abstract Background We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. Methods This study was a randomised, controlled experiment with a cros...
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doaj-00fa5bc675364819b35cf58af42d5f772020-11-25T02:42:48ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412018-09-0126111010.1186/s13049-018-0549-3Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive loadPaul Swinton0Alasdair R. Corfield1Chris Moultrie2David Percival3Jeffrey Proctor4Neil Sinclair5Zane B. Perkins6Emergency Medical Retrieval Service, ScotSTAR, Scottish Ambulance ServiceRoyal Alexandra HospitalRoyal Alexandra HospitalEmergency Medical Retrieval Service, ScotSTAR, Scottish Ambulance ServiceEmergency Medical Retrieval Service, ScotSTAR, Scottish Ambulance ServiceScottish Ambulance Service, Clinical DirectorateCentre for Trauma Sciences, Queen Mary, University of LondonAbstract Background We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. Methods This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs. Following a two-week washout period, each team performed the corresponding simulation. The primary outcome was intervention time. Secondary outcomes were safety-related incidents and errors, and degree of cognitive load. Results In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds; p = < 0.001). The experimental method also significantly reduced procedural errors (0 versus 9, p = 0.007) and the cognitive load experienced by the intubator assistant (41.9 versus 68.7 mm, p = 0.006). Conclusions Pre-preparation of PHEA equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third.http://link.springer.com/article/10.1186/s13049-018-0549-3AirwayIntubationEmergencyPatient safety / safetyHuman errorDrug preparation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paul Swinton Alasdair R. Corfield Chris Moultrie David Percival Jeffrey Proctor Neil Sinclair Zane B. Perkins |
spellingShingle |
Paul Swinton Alasdair R. Corfield Chris Moultrie David Percival Jeffrey Proctor Neil Sinclair Zane B. Perkins Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Airway Intubation Emergency Patient safety / safety Human error Drug preparation |
author_facet |
Paul Swinton Alasdair R. Corfield Chris Moultrie David Percival Jeffrey Proctor Neil Sinclair Zane B. Perkins |
author_sort |
Paul Swinton |
title |
Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load |
title_short |
Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load |
title_full |
Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load |
title_fullStr |
Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load |
title_full_unstemmed |
Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load |
title_sort |
impact of drug and equipment preparation on pre-hospital emergency anaesthesia (phea) procedural time, error rate and cognitive load |
publisher |
BMC |
series |
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
issn |
1757-7241 |
publishDate |
2018-09-01 |
description |
Abstract Background We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. Methods This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs. Following a two-week washout period, each team performed the corresponding simulation. The primary outcome was intervention time. Secondary outcomes were safety-related incidents and errors, and degree of cognitive load. Results In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds; p = < 0.001). The experimental method also significantly reduced procedural errors (0 versus 9, p = 0.007) and the cognitive load experienced by the intubator assistant (41.9 versus 68.7 mm, p = 0.006). Conclusions Pre-preparation of PHEA equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. |
topic |
Airway Intubation Emergency Patient safety / safety Human error Drug preparation |
url |
http://link.springer.com/article/10.1186/s13049-018-0549-3 |
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