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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients managed with Emergency Manual access | Experimental | Consecutive priority 1 patients managed by resuscitation teams with access to an Emergency Manual |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Emergency Manual | Other | Collection of crisis checklists and fact sheets |
|
| 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 |
| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eric Dryver, MD | Contact | +46-738-198261 | eric.dryver@med.lu.se | |
| Ulf Ekelund, MD PhD | Contact | +46-702-049480 | ulf.ekelund@med.lu.se |
| Name | Affiliation | Role |
|---|---|---|
| Eric Dryver, MD | Skane's University Hospital in Lund, Emergency Department | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37848292 | Derived | Dryver E, Olsson de Capretz P, Mohammad M, Armelin M, Dupont WD, Bergenfelz A, Ekelund U. Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol. BMJ Open. 2023 Oct 17;13(10):e071545. doi: 10.1136/bmjopen-2022-071545. |
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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:
| Up to 8 weeks |
| ID | Term |
|---|---|
| D004417 | Dyspnea |
| D002637 | Chest Pain |
| D015746 | Abdominal Pain |
| D013575 | Syncope |
| D012640 | Seizures |
| D014717 | Vertigo |
| D014947 | Wounds and Injuries |
| D006967 | Hypersensitivity |
| D005334 | Fever |
| D006323 | Heart Arrest |
| D011014 | Pneumonia |
| D001919 | Bradycardia |
| D013610 | Tachycardia |
| D012769 | Shock |
| D002056 | Burns |
| D011041 | Poisoning |
| D016883 | Diabetic Ketoacidosis |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012817 | Signs and Symptoms, Digestive |
| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
| D015837 | Vestibular Diseases |
| D007759 | Labyrinth Diseases |
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D007154 | Immune System Diseases |
| D001832 | Body Temperature Changes |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D008171 | Lung Diseases |
| D001145 | Arrhythmias, Cardiac |
| D010335 | Pathologic Processes |
| D000075224 | Cardiac Conduction System Disease |
| D064419 | Chemically-Induced Disorders |
| D007662 | Ketosis |
| D000138 | Acidosis |
| D000137 | Acid-Base Imbalance |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
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