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ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study

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  • David Peran, Charles University, Secondary Nursing School and Nursing College in Prague, Prague Emergency Medical Services
  • ,
  • Jiri Kodet, Motol University Hospital, Prague Emergency Medical Services
  • ,
  • Jaroslav Pekara, Prague Emergency Medical Services, Medical College, Prague
  • ,
  • Lucie Mala, Secondary Nursing School and Nursing College in Prague
  • ,
  • Anatolij Truhlar, Charles University, Emergency Medical Services of the Hradec Kralove Region, Hradec Kralove, Czech Republic; Department of Anaesthesiology and Intensive Care, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
  • ,
  • Patrik Christian Cmorej, Jan Evangelista Purkyne University in Usti nad Labem, Emergency Medical Services of the Usti nad Labem Region
  • ,
  • Kasper Glerup Lauridsen
  • Ferenc Sari, Skellefteå District General Hospital
  • ,
  • Roman Sykora, Charles Darwin University, Emergency Medical Services of Karlovy Vary Region

BACKGROUND: The 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.

METHODS: The 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.

RESULTS: The 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.

CONCLUSION: The 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.

Original languageEnglish
Article number95
JournalBMC Emergency Medicine
Volume20
ISSN1471-227X
DOIs
Publication statusPublished - Dec 2020

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