Abstract
BackgroundThe so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.MethodsThe development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council.A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios.The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured.ResultsThe Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR = 1.17, 95% CI: 1.02 to 1.35, p = 0.023) which were significantly more frequently performed in proper order (220: 338; OR = 1.68, 95% CI: 1.40 to 2.02, p < 0.0001). The use of ABCDE CAT did not prolong the time of patient assessment.ConclusionThe cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.
Highlights
The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment
The primary and main objective of this study is to develop an ABCDE cognitive aid (CA) tool (CAT)
The use of the ABCDE CAT was associated with more performed assessment steps (804 steps without and 868 with the CAT; Odds ratio (OR) = 1.17, 95% CI: 1.02 to 1.35, p = 0.02) which were significantly more frequently performed in proper order
Summary
The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The ABCDE assessment (Airway-Breathing-CirculationDisability-Exposure) is the standard of care used by the European Resuscitation Council for advanced life support and many other international organisations in every patient examination. It is referred to in several parts of the European Resuscitation Council (ERC) Guidelines 2015 [1,2,3,4] and is a part of the curriculum of the ERC Advanced Life Support (ALS) Provider Course as an international standardised course [5]. To the best of our knowledge there is no published ABCDE tool used as a cognitive aid (CA) so far and studies addressed this topic are lacking. The effect of each CA should be tested and validated before implementation into the practice
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