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Cognitive aids used in simulated resuscitation: A systematic review
Sabine Nabecker1, Kevin Nation2, Elaine Gilfoyle3
1Department of Anesthesiology and Pain Management, Sinai Health System, University of Toronto, Toronto, Canada.
Resuscitation Plus
|June 14, 2024
Summary
Cognitive aids improve cardiopulmonary resuscitation (CPR) quality for healthcare professionals but may harm lay providers. Further research is needed due to low certainty evidence from simulation studies.
Area of Science:
- Medical Education
- Emergency Medicine
- Clinical Practice Guidelines
Background:
- Cognitive aids are tools designed to assist healthcare professionals during complex medical procedures.
- Their effectiveness during resuscitation, particularly cardiopulmonary resuscitation (CPR), is an area of ongoing research.
- Standardizing CPR quality and performance is crucial for patient outcomes.
Purpose of the Study:
- To systematically review and compare the effectiveness of cognitive aid use versus no cognitive aid use during resuscitation.
- To evaluate the impact of cognitive aids on CPR quality and performance in various populations.
Main Methods:
- A systematic review following PICOST format, including randomized controlled trials and non-randomized studies of simulated resuscitation.
- Searches of Medline, Embase, and Cochrane databases up to April 2024.
- Risk of bias and certainty of evidence assessed using RoB2, ROBINS-I, and GRADE, respectively.
Main Results:
- 29 studies were included, focusing solely on simulation data; no clinical patient studies were identified.
- Cognitive aids demonstrated benefits for healthcare professionals in neonatal, pediatric, and adult advanced life support simulations.
- Undesirable effects were reported for lay providers using cognitive aids in simulated resuscitations.
- A meta-analysis was not feasible due to significant methodological heterogeneity.
Conclusions:
- Cognitive aids are suggested for healthcare professionals during resuscitation due to observed benefits in simulations.
- Use of cognitive aids is not suggested for lay providers based on current low certainty evidence.
- The evidence base is limited by indirectness, risk of bias, inconsistency, and imprecision.
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