Trial reportRegional anesthesia and pain medicine
Adherence to guidelines for the management of local anesthetic systemic toxicity is improved by an electronic decision support tool and designated "Reader".
Trial report in Regional anesthesia and pain medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Computer-generated reminders delivered on paper to healthcare professionals: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2017Pooled it
- The Internet, Apps, and the Anesthesiologist.Healthcare (Basel, Switzerland) · 2023Review
- Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence.Children (Basel, Switzerland) · 2023Review
- Update on Local Anesthetic Toxicity, Prevention and Treatment During Regional Anesthesia in Infants and Children.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Review
- Data Model Requirements for a Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management.Applied clinical informatics · 2020Article
- Implementation and Evaluation of a Web-Based Distribution System For Anesthesia Department Guidelines and Standard Operating Procedures: Qualitative Study and Content Analysis.Journal of medical Internet research · 2019Article
- A Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management: Results of the User-Centered Design Process.JMIR mHealth and uHealth · 2019Article
- Impact of Critical Event Checklists on Anaesthetist Performance in Simulated Operating Theatre Emergencies.Cureus · 2019Article
- Study protocol for the Anesthesiology Control Tower-Feedback Alerts to Supplement Treatments (ACTFAST-3) trial: a pilot randomized controlled trial in intraoperative telemedicine.F1000Research · 2018Article
- Helping experts and expert teams perform under duress: an agenda for cognitive aid research.Anaesthesia · 2017Article
- Paper or plastic? Simulation based evaluation of two versions of a cognitive aid for managing pediatric peri-operative critical events by anesthesia trainees: evaluation of the society for pediatric anesthesia emergency checklist.Journal of clinical monitoring and computing · 2016Article
- From Socrates to Virtual Reality: A Historical Review of Learning Theories and Their Influence on the Training of Anesthesiologists.The journal of education in perioperative medicine : JEPMArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
objectivesA hardcopy or paper cognitive aid has been shown to improve performance during the management of simulated local anesthetic systemic toxicity (LAST) when given to the team leader. However, there remains room for improvement to ensure a system that can achieve perfect adherence to the published guidelines for LAST management. Recent research has shown that implementing a checklist via a designated reader may be of benefit. Accordingly, we sought to investigate the effect of an electronic decision support tool (DST) and designated "Reader" role on team performance during an in situ simulation of LAST.
methodsParticipants were randomized to Reader + DST (n = 16, rDST) and Control (n = 15, memory alone). The rDST group received the assistance of a dedicated Reader on the response team who was equipped with an electronic DST. The primary outcome measure was adherence to guidelines.
resultsFor overall and critical percent correct scores, the rDST group scored higher than Control (99.3% vs 72.2%, P < 0.0001; 99.5% vs 70%, P < 0.0001, respectively). In the LAST scenario, 0 (0%) of 15 in the control group performed 100% of critical management steps, whereas 15 (93.8%) of 16 in the rDST group did so (P < 0.0001).
conclusionsIn a prospective, randomized single-blinded study, a designated Reader with an electronic DST improved adherence to guidelines in the management of an in situ simulation of LAST. Such tools are promising in the future of medicine, but further research is needed to ensure the best methods for implementing them in the clinical arena.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.