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Research article
Christopher Neuhaus
University Hospital Heidelberg
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7262-3723
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background : Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency.
Methods : 37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine.
Results : We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p=0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p=0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm.
Conclusions : Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.
Keywords
Human factors, briefings, checklists, mental models, airway management, simulation
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
No community comments so far
Editorial decision: Accept
On 10 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
Version 2
Posted 20 Nov, 2019
No comments provided
Editorial decision: Minor revision
On 06 Dec, 2019
Review #2 received
Received 04 Dec, 2019
Review #1 received
Received 19 Nov, 2019
Reviewer #2 agreed
On 16 Nov, 2019
Editor assigned
On 15 Nov, 2019
Reviewers invited
Invitations sent on 15 Nov, 2019
Reviewer #1 agreed
On 15 Nov, 2019
Submission checks complete
On 14 Nov, 2019
Editor invited
On 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 26 Oct, 2019
Review #3 received
Received 22 Oct, 2019
Review #2 received
Received 09 Oct, 2019
Reviewer #3 agreed
On 07 Oct, 2019
Review #1 received
Received 02 Oct, 2019
Reviewer #1 agreed
On 01 Oct, 2019
Reviewer #2 agreed
On 01 Oct, 2019
Editor assigned
On 03 Sep, 2019
Reviewers invited
Invitations sent on 03 Sep, 2019
Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 18 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Christopher Neuhaus
University Hospital Heidelberg
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7262-3723
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
No community comments so far
Editorial decision: Accept
On 10 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
Version 2
Posted 20 Nov, 2019
No comments provided
Editorial decision: Minor revision
On 06 Dec, 2019
Review #2 received
Received 04 Dec, 2019
Review #1 received
Received 19 Nov, 2019
Reviewer #2 agreed
On 16 Nov, 2019
Editor assigned
On 15 Nov, 2019
Reviewers invited
Invitations sent on 15 Nov, 2019
Reviewer #1 agreed
On 15 Nov, 2019
Submission checks complete
On 14 Nov, 2019
Editor invited
On 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 26 Oct, 2019
Review #3 received
Received 22 Oct, 2019
Review #2 received
Received 09 Oct, 2019
Reviewer #3 agreed
On 07 Oct, 2019
Review #1 received
Received 02 Oct, 2019
Reviewer #1 agreed
On 01 Oct, 2019
Reviewer #2 agreed
On 01 Oct, 2019
Editor assigned
On 03 Sep, 2019
Reviewers invited
Invitations sent on 03 Sep, 2019
Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 18 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Anesthesiology.
Background : Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency.
Methods : 37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine.
Results : We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p=0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p=0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm.
Conclusions : Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.
Figure 1
Figure 2
Figure 3
Figure 4
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