id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
anesthj-88	Hacker, James B; Johnson, Paul M; Bruner, Sandra; Parrott, Justice; Alguire, Katherine; Uranga, Tiffany; Yauger, Sunny J; Nayback-Beebe, Ann	Use of a High-Fidelity Patient Simulator to Introduce an Evidence-Based Emergency Manual into Certified Registered Nurse Anesthetist Practice	2022	7	.pdf	application/pdf	3800	201	48	The overall incidence of perioperative critical events has been estimated at 145 events per year for a hospital that performs 10,000 operations.2,3 Thus, critical events may be so rare that individual anesthesia providers never experience them in practice, preventing opportunities to form pattern recognition, which is a key characteristic of expert clinical decision-making.4 CRNAs are expected to rely on memory alone to recall key actions and seamlessly manage a wide array of critical events, therefore, mismanagement or deviation from accepted practice due to human error, may account for a substantive portion of anesthesia- related risk.5 Utilization of an emergency manual (EM) can increase the number of key actions completed by anesthesia providers during low-frequency, high-risk perioperative critical events.6-10 In 1924, Babcock expressed if a critical event during surgery required a response that was not instantly obtained by simple measures, a fixed emergency routine should be posted on the walls of every operating room, drilled into every staff member, and strictly enforced.11 Over 90 years later, there remains a cultural reluctance among anesthesia providers towards use of emergency checklists during perioperative critical events, with one study reporting 60% of anesthesia residents believing they should be able to manage a critical event from memory alone.6 Substantial evidence indicates anesthesia providers routinely do not remember all actions involved in managing emergent events from memory alone.12 Indeed, three recent editorials make the same plea as Babcock did in 1924, concluding it is time to adopt the use of emergency routines during the perioperative period.11 Several studies demonstrate healthcare providers perform poorly when relying solely on memory to manage simulated critical events.8,13-16 For instance, Smith et al found a rapid decline in Advanced Cardiac Life Support (ACLS) skills among nurses after 3 and 12 months post-training, (30% and 14% of nurses, respectively).13 Regardless of these issues, the drastic change in key task performance proved invaluable when demonstrating the importance of using an EM for the management of critical anesthesia events.	cache/anesthj-88.pdf	txt/anesthj-88.txt