ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study.

Area of Science:

• Emergency Medicine
• Medical Education
• Clinical Assessment

Background:

• The ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a standard for patient assessment.
• The effectiveness of cognitive aids (CA) in resuscitation and peri-arrest situations requires further investigation.
• This study focuses on developing and evaluating an ABCDE CA tool (CAT).

Purpose of the Study:

• To develop a cognitive aid tool (CAT) for the ABCDE patient assessment.
• To evaluate the impact of the ABCDE CAT on the quality and efficiency of patient assessment in simulated clinical scenarios.
• To address the knowledge gap regarding the efficacy of cognitive aids in critical care settings.

Main Methods:

• The ABCDE CAT was developed using a modified Delphi method involving resuscitation experts.
• A pilot multicentre study with 48 paramedic students assessed the tool's impact in simulated pre-post cohorts.
• Assessment steps, order, and time were recorded in simulated clinical scenarios.

Main Results:

• The ABCDE CAT was successfully developed through expert consensus.
• Use of the ABCDE CAT was linked to a higher number of performed assessment steps (OR=1.17, p=0.023).
• Steps were performed significantly more frequently in the correct order with the CAT (OR=1.68, p<0.0001) without increasing assessment duration.

Conclusions:

• A cognitive aid for the ABCDE approach has been developed.
• The ABCDE CAT enhances paramedic performance by increasing the number and correct sequencing of assessment steps.
• The tool is effective in advanced life support and peri-arrest care without prolonging patient assessment time.