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EMERGENCY MANUAL

Checklist Boards Corporation, with permission from the Stanford Anesthesia Cognitive Aid Group (SACAG), has agreed to provide copies of the Stanford Emergency Manual to our clients at our cost. The manuals are printed on paper that can be cleaned, in binder that allows for easy access to emergency procedure checklists in the operating room. More information can be found at http://emergencymanual.stanford.edu/ contact us for order information.

Abstract: Simulation-based trial of surgical-crisis checklists.

BACKGROUND:
Operating-room crises (e.g., cardiac arrest and massive hemorrhage) are common events in large hospitals but can be rare for individual clinicians. Successful management is difficult and complex. We sought to evaluate a tool to improve adherence to evidence-based best practices
during such events.

METHODS:
Operating-room teams from three institutions (one academic medical center and two community hospitals) participated in a series of surgical-crisis scenarios in a simulated operating room. Each team was randomly assigned to manage half the scenarios with a set of crisis checklists and the remaining scenarios from memory alone. The primary out come measure was failure to adhere to critical processes of care. Participants were also surveyed regarding their perceptions of the usefulness and clinical relevance of the checklists.

RESULTS:
A total of 17 operating-room teams participated in 106 simulated surgical-crisis scenarios. Failure to adhere to lifesaving processes of care was less common during simulations when checklists were available .... Every team performed better when the crisis checklists were available than when they were not. A total of 97% of the participants reported that if one of these crises occurred while they were undergoing an operation, they would want the checklist used.

CONCLUSIONS:
... checklist use was associated with significant improvement in the management of operating-room crises. These findings suggest that checklists for use during operating-room crises have the potential to improve surgical care.

Authors:
Arriaga AF1, Bader AM, Wong JM, Lipsitz SR, Berry WR, Ziewacz JE, Hepner DL, Boorman DJ, Pozner CN, Smink DS, Gawande AA.
N Engl J Med. 2013 Jan 17;368(3):246-53. doi: 10.1056/NEJMsa1204720.

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