Cognitive aids in thoracic emergencies

This review summarizes anesthetic challenges in up-to-date developments of cognitive aids in thoracic anesthesia emergencies. Recent advancements demonstrate a progression toward structured, algorithm-driven approaches that mitigate cognitive overload, enhance team coordination, and support clinical decision-making during rare, high-stakes events such as massive hemoptysis, tracheobronchial obstruction, mediastinal mass syndrome, or pericardial tamponade.

Evidence highlights that cognitive aids - ranging from checklists and flowcharts to simulation-based mnemonics - improve recall, technical performance, and interdisciplinary communication, thereby reducing errors and omissions of essential steps in the acute setting, although they cannot substitute clinical judgement. While several conditions, including massive hemoptysis and mediastinal masses, are supported by structured frameworks, others such as bronchopleural fistula, aortoesophageal fistula, or diaphragmatic rupture still lack standardized tools and yet depend largely on institutional case-based experience and expert opinion.

Well-designed cognitive aids facilitate critical priorities such as airway protection, bleeding control, and hemodynamic stabilization, and guide complex multidisciplinary interventions like bronchial artery embolization or thoracic endovascular aortic repair. Their successful use requires appropriate design and thoughtful integration into local practice, simulation training, and crisis resource management. Future efforts should focus on systematic development and validation of specialty-specific tools to optimize patient outcomes and strengthen resilience in thoracic anesthesia crisis management.