The effects of a displayed cognitive aid on non-technical skills in a simulated 'can't intubate, can't oxygenate' crisis

Guidelines outlining recommended actions are difficult to implement in the stressful, time-pressured situation of an airway emergency. Cognitive aids such as posters and algorithms improve performance during some anaesthetic emergencies; however, their effects on team behaviours have not been determined. In this study, 64 participants were randomly assigned into control (no cognitive aid) and intervention (cognitive aid provided) groups before a simulated can t intubate, can t oxygenate scenario. Video analysis was undertaken of the non-technical skills and technical performance during the scenarios. All categories had higher Anaesthetists Non-Technical Skills (ANTS) scores when a cognitive aid was supplied (mean (SD) total ANTS score 10.4 (3.1) vs 13.2 (2.4), p <0.001). The number of times the cognitive aid was used was associated with higher ANTS scores (? = 0.383, p = 0.002). A trend towards the establishment of an infraglottic airway within 3 min was also noted (control group 55.3 vs intervention 76.9 , p = 0.076). Non-technical skills are improved when a cognitive aid is present during airway emergencies.