| ASRA Checklist Improves Trainee Performance During a Simulated Episode of Local Anesthetic Systemic Toxicity. | |
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MedLine Citation:
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PMID: 22157743 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Severe local anesthetic systemic toxicity (LAST) is a rare event, the management of which might best be learned using high-fidelity simulation. In its 2010 Practice Advisory, the American Society of Regional Anesthesia and Pain Medicine (ASRA) created a medical checklist to aid in the management of LAST. We hypothesized that trainees provided with this checklist would manage a simulated episode of LAST more effectively than those without it. A secondary aim of the study was to assess the ASRA Checklist's usability and readability. METHODS: Trainees undergoing a simulated LAST event were randomized to the checklist group (n = 12) or the no-checklist group (n = 13). Our primary outcome was the number of medical management tasks completed correctly. Secondary outcomes included assessment of the anesthesiologists' nontechnical skills and posttest performance. RESULTS: Trainees receiving the checklist demonstrated superior medical management of the simulated LAST event: the checklist group correctly performed 16.0 (2.6) tasks versus the no-checklist group's 8.8 (3.0) tasks (mean [SD], P < 0.001). The checklist group had higher decision making scores on the anesthesiologists' nontechnical skills assessment (5.2 [1.8] versus 4.0 [1.35] summed rater score, P = 0.037) and had higher knowledge retention 2 months later (P = 0.031). Of those trainees randomized to receive the checklist, 7 of 12 used it fully (versus partially), which was reflected in higher medical and nontechnical performance scores. CONCLUSIONS: Use of the ASRA Checklist significantly improved the trainees' medical management and nontechnical performance during a simulated episode of severe LAST. Partial use of the checklist correlated with lower overall performance. |
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Authors:
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Joseph M Neal; Robert L Hsiung; Michael F Mulroy; Brian B Halpern; Alison D Dragnich; April E Slee |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-6 |
Journal Detail:
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Title: Regional anesthesia and pain medicine Volume: - ISSN: 1532-8651 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Departments of *Anesthesiology and †Nursing Education, Virginia Mason Medical Center; and ‡Biostatistics, Axio Research, Seattle, WA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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