Influence of airway trolley organization on efficiency and team performance: A randomized, crossover simulation study

Area of Science:

• Anesthesiology
• Patient Safety
• Medical Device Design

Background:

• Unanticipated difficult airway management is a major cause of anesthesia-related complications.
• Difficult Airway Trolley (DAT) design may impact outcomes in airway emergencies.
• Optimizing DATs is crucial for improving patient safety during anesthesia.

Purpose of the Study:

• To evaluate if an algorithm-based DAT with integrated cognitive aids enhances efficiency and team performance in simulated difficult airway scenarios.
• To compare the performance of an algorithm-based DAT versus a standard DAT.

Main Methods:

• A crossover design study involving 16 teams (anesthetist, nurse anesthetist, assistant nurse).
• Teams performed two simulated unanticipated difficult airway scenarios using both an algorithm-based DAT and a standard DAT.
• Outcome measures included objective efficiency, team performance, and subjective user ratings.

Main Results:

• The algorithm-based DAT led to fewer deviations from the difficult airway algorithm and reduced unnecessary drawer openings.
• No significant differences were found in time to retrieve airway devices or time to first effective ventilation.
• Participants showed a strong preference for the algorithm-based DAT, despite no significant difference in overall team performance.

Conclusions:

• Algorithm-based DATs with cognitive aids may improve efficiency in managing difficult airways compared to standard trolleys.
• These findings suggest potential improvements for anesthetic practice and patient safety.
• Further research into DAT design optimization is warranted.