Checklists Resuscitation Emergency Department

Study Overview
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Brief Summary
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The study will systematically evaluate how an emergency manual-a collection of checklists and fact sheets-affects the performance of resuscitation teams during the management of priority one patients in an emergency department.

Detailed Description
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Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). This six-month-long study prospectively evaluates a digital emergency manual-a collection of crisis checklists and fact sheets-during the management of priority 1 patients in the Skåne University Hospital at Lund's ED.

Official Title
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Clinical Use of an Emergency Manual by Resuscitation Teams and Impact on Performance in the Emergency Department

Conditions
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Shortness of Breath, Chest Pain, Abdominal Pain, Altered Mental Status, Syncope, Seizures, Vertigo, Trauma, Allergic Reaction, Fever, Cardiac Arrest, Asthma Acute, COPD Exacerbation Acute, Pneumonia, Pulmonary Edema - Acute, Bradycardia, Tachycardia, Shock, Burns, Poisoning, Diabetic Ketoacidosis, Hyperglycemic Hyperosmolar Nonketotic Syndrome

Intervention / Treatment
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* Other: Emergency Manual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive priority 1 patients managed in the resuscitation room of Skåne University Hospital at Lund's Emergency Department Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients managed with Emergency Manual access<br>Consecutive priority 1 patients managed by resuscitation teams with access to an Emergency Manual | Other: Emergency Manual<br>* Collection of crisis checklists and fact sheets<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of indication of interventions performed thanks to Do-Confirm Emergency Manual use | The primary outcome measures are the proportions of interventions performed thanks to Do-Confirm EM use graded as indicated, of neutral relevance, and not indicated. | 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Team's subjective evaluation of Emergency Manual value | The team's subjective evaluation of the EM's value is recorded prior to the logging out from the EM using a Likert scale of 1 to 6. | 1 hour | 
| Degree of indication of interventions that might have been performed had the Emergency Manual been used | Fifty patients that presented during the six-month period preceding EM implementation, are identified. These 50 patients are selected based on matching to the 50 patients where the EM was used, using age, presenting complaint and relevant co-morbidities. In addition, fifty patients where the EM was not used during the pilot study period are also identified based on the same matching process. The EM is accessed to determine whether additional interventions would have been performed, had the EM been used. All interventions-those actually performed as well as those that might have been performed had the EM been used-are then assessed for degree of indication by three external reviewers. | 1 hour | 
| Structured interviews | Teams can electronically request contact with the investigators to report specific events related to EM use. If so, the following data is extracted during a structured interview: patient age, sex, presenting complaint and suspected diagnosis seniority of the physician initially in charge of the case events or concerns relating to EM use mode of EM use (Do-Confirm, Read-Do, Sampling) and sections relevant to the case personnel's assessment of the impact of the EM on patient care personnel's assessment of impact of the EM on team members and teamwork personnel's suggestions for EM improvement | Up to 8 weeks |