• Christopher Neuhaus, Johannes Schäfer, Markus A Weigand, and Christoph Lichtenstern.
• Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld, 110 69120, Heidelberg, Germany. c.neuhaus@uni-heidelberg.de.
• BMC Anesthesiol. 2019 Dec 18; 19 (1): 232.

BackgroundHuman factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency.Methods37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a "cannot ventilate, cannot oxygenate" scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine.ResultsWe observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p = 0.36). There was a significant difference in groups' choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p = 0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm.ConclusionsOur study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.

This article appears in the collection: Decision Making in Anaesthesia & Critical Care.

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