Using eye tracking technology to compare the effectiveness of malignant hyperthermia cognitive aid design / 대한마취과학회지

BACKGROUND: Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology. METHODS: With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants. Recordings were reviewed and annotated to measure the time required for participants to locate objects on the cognitive aid to provide an answer; cumulative time to answer was the primary outcome. RESULTS: For the primary outcome, there were differences detected between cumulative time to answer survival curves (P < 0.001). Participants demonstrated the shortest cumulative time to answer when viewing the Society for Pediatric Anesthesia (SPA) cognitive aid compared to four other publicly available cognitive aids for malignant hyperthermia, and this outcome was not influenced by the anesthesiologists’ years of experience. CONCLUSIONS: This is the first study to utilize eye tracking technology in a comparative evaluation of cognitive aid design, and our experience suggests that there may be additional applications of eye tracking technology in healthcare and medical education. Potentially advantageous design features of the SPA cognitive aid include a single page, linear layout, and simple typescript with minimal use of single color blocking.

Listas de chequeo: crisis en Obstetricia / Checklists: obstetric crisis

Introducción: Las crisis en la atención de la paciente obstétrica son eventos pocos frecuentes, pero de presentarse requieren de un manejo rápido y adecuado. Actualmente hay evidencia que las listas de chequeo pueden contribuir a un mejor desenlace. Objetivo: Confeccionar una herramienta adaptada a la realidad del Uruguay que nos sirva de ayuda cognitiva frente a una situación de crisis en la población obstétrica. Métodos: El grupo de trabajo decidió cuáles era las listas de chequeo que iban a conformar el manual. Para las confección de las mismas se tuvo en cuenta las realizadas por Ariadne Labs. En cada uno de los temas se valoró la bibliografía actualizada y la evidencia de la misma. Resultados: Se realizaron 11 listas de chequeo de crisis en obstetricia, las cuales se adaptaron a los tratamientos y fármacos disponibles en nuestro país. Las mismas pueden ser descargadas en forma gratuita. Discusión y conclusiones: Luego de analizar la literatura disponible que apoya el uso de las listas de chequeo y concluye que su uso permite un mejor desenlace frente a una crisis. Dicha herramienta es una más junto con las ya existentes que puede ser de gran ayuda en una situación de crisis, pero que por sí sola no cambia el desenlace. Se presentó un manual de emergencias obstétricas con contenido claro, actualizado y adaptado a nuestro país.

Introduction: Crisis in patients in obstetrical care are unlikely events. If they occur, it is required to deal with them promptly and skillfully. Nowadays, there is evidence that checklists can help to achieve a better outcome. Objective: To create a tool suitable for the Uruguayan circumstances. This tool will provide cognitive aid in situations of crisis in the obstetric population. Methods: The work group decided on the checklists to be included in the handbook. Checklists made by Ariadne Labs were taken into consideration. Throughout all stages of this work, updated bibliography and scientific evidence were considered. Results: Eleven checklists were made on patients with obstetric crisis. These were created given the treatments and drugs available in Uruguay, moreover, they can be downloaded free of charge. Discussion and conclusions: After careful study of the available papers that supports the use of checklists, they conclude that the use of these, provide a better outcome when dealing with a crisis. In addition, there are many existing tools extremely beneficial in this situation. However, the use of checklist in isolation is not enough to guarantee a positive result. A handbook of obstetric emergency was presented featuring a clear and updated content, which is suitable to this country reality.