Local hospitals join forces to lead development of the UK’s first theatre prompt cards

launch_3When airlines pilots experience a mid-air emergency they have an onboard checklist to ensure that key safety steps are not missed.

However, when the unexpected occurs in the operating theatre, medical teams have historically not had a document they can refer to.

While they are trained in management of critical incidents, evidence from the United States has found that in a crisis and in times of stress, key actions can be missed.

Now a group of consultant anaesthetists from Royal Surrey County Hospital and Ashford and St, Peter’s Hospitals, led by Doctor Suzi Lomax, Doctor Wendy King and Dr Rob Menzies, have developed emergency prompt cards for theatre staff.

Known as SCReaM – Surrey Crisis Resource Management – the initiative provides an additional safety mechanism to ensure that during moments of high pressure, key lifesaving treatment steps are not missed.

Consultant Anaesthetist Wendy King, said: “The introduction of this exciting theatre safety initiative has been driven by our commitment to improve patient safety across both Trusts.

launch_2“Around the world every year around 234 million operations take place and it is estimated that things do not go to plan in around 3 million of those cases.

“At Royal Surrey this equates to around one incident every day, most of which won’t be life threatening, but still the team’s performance is key to ensuring that the risk to the patient is minimised.

“Experienced pilots have been using cognitive aids for years during emergencies to ensure that they complete key actions during a crisis and they could not believe that we were still expected to memorise everything.”

The team, who are also working in collaboration with the University of Surrey, started developing the idea after visiting the US, where similar cards have been found to improve the performance of surgical teams and potentially improve patient outcomes.

The prompt cards, which feature guidance on 33 different emergencies, ranging from cardiac arrest to breathing difficulties, will be available to staff from today.

As well as the formal steps that should be taken for each emergency, the cards also provide the recommended drug dosage, where the drugs/equipment can be found and the contact numbers for different specialists.

Ahead of their introduction theatre staff, from scrub nurses to consultant surgeons, have taken part in human factors/ Crew Resource Management (CRM) training, which has been delivered by both clinicians and aviation pilots.

launch_1The Captain who successfully managed to land an airliner full of people in the Hudson River, Manhattan, without a single loss of life credited their CRM training with ensuring they had the skills and the tools needed to open lines of communication and work together.

Theatre staff have also taken part in multidisciplinary high fidelity simulations in a mock theatre to ensure that the cards have become embedded into their practice.

“Many of the practices outlined on the cards will be second nature to my colleagues and I, but they provide an additional safety mechanism for those rare, life threatening emergencies by reducing the risk that key steps will be missed out which ultimately could affect the patient,” added Consultant Anaesthetist Suzi Lomax.

©2017 Royal Surrey County Hospital

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