The Use of a Pediatric Trauma Checklist to Improve Clinical Performance in a Simulated Trauma Resuscitation: a Randomized Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 56
- Locations
- 1
- Primary Endpoint
- Time measurement interval to initiation of bag mask ventilation
Study Overview
Brief Summary
The use of a pre-arrival and pre-departure trauma checklist to optimize care has not yet been studied. The Alberta Children's Hospital (ACH) Trauma Checklist was developed by the ACH Resuscitation Council with input from the ACH Trauma Program. The purpose of this study is to determine if the introduction of the ACH Trauma Checklist as a cognitive aid, coupled with an educational session, will improve clinical performance in a simulated environment. The investigators plan to conduct a pilot, randomized control trial assessing the impact of the ACH trauma checklist on time to critical interventions on a simulated pediatric patient by multidisciplinary teams. The investigators hypothesize that teams who use a trauma checklist as a cognitive aid will have faster initiation of key clinical interventions within a simulated pediatric trauma resuscitation. Improvements in performance in a simulated environment with this tool may translate to similar results in the clinical setting.
Detailed Description
Research Aims:
Aim 1: To evaluate the effectiveness of a pre-arrival, pre-departure trauma checklist on improving time to initiation of key clinical interventions in a simulated pediatric trauma scenario
Aim 2: To evaluate the impact of a pre-arrival, pre-departure trauma checklist on completion of primary and secondary survey tasks as demonstrated by an Advanced Trauma Life Support (ATLS) performance tool.
Aim 3: To evaluate the cognitive task load of a trauma checklist on emergency department physicians during a simulated trauma resuscitation scenario.
Aim 4: To describe patterns of eye movement of a trauma team leader in a simulated scenario in relation to critical patient interventions and team communication.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Trauma team leader inclusion criteria:
- •Pediatric emergency medicine physician
- •Second physician inclusion criteria:
- •Pediatric emergency medicine physician
- •Nurse inclusion criteria:
- •Pediatric emergency registered nurse
Exclusion Criteria
- •Previous participation in the study
Arms & Interventions
Control Arm
In the control arm, teams will not receive a copy of the checklist for use.
Checklist Arm
In the intervention arm, the participants will watch a 10 minute recorded educational video demonstrating the use of the trauma checklist prior to their simulation scenario. These teams will subsequently receive a copy of the checklist for use during their simulation scenario.
Intervention: Checklist (Other)
Outcomes
Primary Outcomes
Time measurement interval to initiation of bag mask ventilation
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to first assisted bag mask breath
Time measurement interval to initiation of endotracheal tube placement
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to endotracheal tube placement
Time measurement interval to initiation of paralytic medication
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to delivery of intubation paralytic medication
Time measurement interval to application of pelvic binder
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to application of pelvic binder
Time measurement interval to initiation of induction medication
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to delivery of intubation induction medication
Time measurement interval to initiation of fluid bolus administration
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to initiation of first crystalloid fluid bolus
Time measurement interval to completion of log roll
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to completion of patient log roll
Time measurement interval to initiation of blood product administration
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to initiation of first blood product administration
Time measurement interval to Glasgow Coma Score calculation
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to first verbalized and calculated Glasgow Coma Score
Time measurement interval to initiation of hyperosmolar therapy
Time Frame: within the 20 minute simulation scenario
Interval from start of scenario to initiation of hyperosmolar therapy, either mannitol or 3% saline
Secondary Outcomes
- Eye movements of the trauma team leader(within the 20 minute simulation scenario)
- Advanced Trauma Life Support Task Performance(within the 20 minute simulation scenario)
- Checklist completion(within the 20 minute simulation scenario)