Checklists of The Colombian Society of Anesthesiology and Resuscitation (S.C.A.R.E.) for managing critical events in the OR: Translation and evidence-based update
Critical intraoperative events are rare and may sometimes be managed poorly and too late.
To translate and update the checklists developed by Ariadne Labs for management of critical events in the OR and to adapt the list for managing anesthetic toxicity, based on secondary clinical evidence.
Materials and methods:
In order to translate and update the checklists, the recommendations given by Ariadne Labs were followed to change the original checklists in accordance with a systematic methodology that comprises three phases: 1) translation of the original lists, 2) systematic literature search, 3) evaluation and selection of evidence, 4) adaptation of the list for managing anesthetic toxicity, 5) changes, deletions, and additions to the translated lists, and 6) layout of the checklists.
The 12 original checklists were translated into Spanish and a new list was adapted for managing toxicity from local anesthetic agents. As a result of the systematic literature search, 1407 references were screened, from which 7 articles were selected and included for evidence-based updating of the new checklists. The layout of the new lists was consistent with the design recommendations of the original lists.
12 translated and updated checklists were submitted and a new list was adapted for the management of local anesthetics toxicity, based on a systematic literature review.
2. Arriaga AF, Bader AM, Wong JM, Lipsitz SR, Berry WR, Ziewacz JE, et al. Simulation-based trial of surgical-crisis checklists. N Engl J Med. 2013;368:246-53.
3. Navarro Vargas JR. Eventos críticos en anestesia. Rev Colomb Anestesiol. 2011;39:573-86.
4. Kurrek MM, Devitt JH, Cohen M. Cardiac arrest in the OR: how are our ACLS skills? Can J Anaesth. 1998;45:130-2.
5. Stross JK. Maintaining competency in advanced cardiac life support skills. JAMA. 1983;249:3339-41.
6. Semeraro F, Signore L, Cerchiari EL. Retention of CPR performance in anaesthetists. Resuscitation. 2006;68:101-8.
7. Smith KK, Gilcreast D, Pierce K. Evaluation of staff's retention of ACLS and BLS skills. Resuscitation. 2008;78:59-65.
8. Lipman SS, Daniels KI, Carvalho B, Arafeh J, Harney K, Puck A, et al. Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises. Am J Obstet Gynecol. 2010;203,179.e1-5.
9. Charuluxananan S, Punjasawadwong Y, Suraseranivongse S, Srisawasdi S, Kyokong O, Chinachoti T, et al. The Thai Anesthesia Incidents Study (THAI Study) of anesthetic outcomes. II. Anesthetic profiles and adverse events. J Med Assoc Thai. 2005;88 Suppl. 7:S14-29.
10. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet (London, England). 2015;385 Suppl. 3:S11.
11. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Size and distribution of the global volume of surgery in 2012. Bull World Health Organ. 2016;94:201-9F.
12. Webb RK, Currie M, Morgan CA, Williamson JA, Mackay P, Russell WJ, et al. The Australian Incident Monitoring Study: an analysis of 2000 incident reports. Anaesth Intensive Care. 1993;21:520-8.
13. Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361:1368-75.
14. Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with major inpatient surgery in medicare patients. Ann Surg. 2009;250:1029-34.
15. Ghaferi AA, Birkmeyer JD, Dimick JB. Hospital volume and failure to rescue with high-risk surgery. Med Care. 2011;49:1076-81.
16. Harrison TK, Manser T, Howard SK, Gaba DM. Use of cognitive aids in a simulated anesthetic crisis. Anesth Analg. 2006;103:551-6.
17. Gaba DM. Perioperative cognitive aids in anesthesia: what, who, how, and why bother? Anesth Analg. 2013;117:1033-6.
18. Wen LY, Howard SK. Value of expert systems, quick reference guides and other cognitive aids. Curr Opin Anaesthesiol 2014;27:643-8.
19. Marshall S. The use of cognitive aids during emergencies in anesthesia: a review of the literature. Anesth Analg. 2013;117:1162-71.
20. Weiser TG, Berry WR. Review article: perioperative checklist methodologies. Can J Anaesth. 2013;60:136-42.
21. Runciman WB, Kluger MT, Morris RW, Paix AD, Watterson LM, Webb RK. Crisis management during anaesthesia: the development of an anaesthetic crisis management manual. Qual Saf Health Care. 2005;14:e1.
22. Glahn KPE, Ellis FR, Halsall PJ, Müller CR, Snoeck MMJ, Urwyler A, et al. Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. Br J Anaesth. 2010;105:417-20.
23. Neal JM, Mulroy MF, Weinberg GL, American Society of Regiona Anesthesia and Pain Medicine. American Society of Regional Anesthesia and Pain Medicine checklist for managing local anesthetic systemic toxicity: 2012 version. Reg Anesth Pain Med. 2012;37:16-8.
24. Goldhaber-Fiebert SN, Howard SK. Implementing emergency manuals: can cognitive aids help translate best practices for patient care during acute events? Anesth Analg. 2013;117:1149-61.
25. Neal JM, Hsiung RL, Mulroy MF, Halpern BB, Dragnich AD, Slee AE ASRA checklist improves trainee performance during a simulated episode of local anesthetic systemic toxicity. Reg Anesth Pain Med. 2012;37:8-15.
26. Marshall SD, Sanderson P, McIntosh CA, Kolawole H. The effect of two cognitive aid designs on team functioning during intra-operative anaphylaxis emergencies: a multi-centre simulation study. Anaesthesia. 2016;71:389-404.
27. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360:491-9.
28. Biccard BM, Rodseth R, Cronje L, Agaba P, Chikumba E, Du Toit L, et al. A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes. S Afr Med J. 2016;106:592-7.
29. Birkmeyer JD. Strategies for improving surgical quality -checklists and beyond. N Engl J Med. 2010;363:1963-5.
30. Mellin-Olsen J, Staender S, Whitaker DK, Smith AF. The Helsinki Declaration on Patient Safety in Anaesthesiology. Eur J Anaesthesiol. 2010;27:592-7.
31. Merry AF, Cooper JB, Soyannwo O, Wilson IH, Eichhorn JH. International Standards for a Safe Practice of Anesthesia 2010. Can J Anaesth. 2010;57:1027-34.
32. Gómez Buitrago LM. La lista de chequeo: un estándar de cuidado. Rev Colomb Anestesiol. 2013;41:182-3.
33. Ariadne Labs. Operating room crisis checklists; 2013 [Internet] [Cited 15 Nov 2016]. Retrieved from www.projectcheck.org/crisis.
34. Ministerio de la Protección Social, COLCIENCIAS. Guía Metodológica para la elaboración de Guías Atención Integral en el Sistema General de Seguridad Social en Salud Colombiano. Bogotá, Colombia; 2010.
35. Cave G, Harrop-Griffiths W,Harvey MG, Meek T, Picard J, Short T, et al. AAGBI safety guideline: management of severse local anaesthetic toxicity; 2010.
36. Jasudavisius A, Arellano R, Martin J, McConnell B, Bainbridge D. A systematic review of transthoracic and transesophageal echocardiography in non-cardiac surgery: implications for point-of-care ultrasound education in the operating room. Can J Anesth Can d'anesthésie. 2015:480-7.
37. Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 1. Executive summary. Resuscitation. 2015;95:1-80.
38. Rosenberg H, Pollock N, Schiemann A, Bulger T, Stowell K. Malignant hyperthermia: a review. Orphanet J Rare Dis Orphanet J Rare Dis. 2015;10:93.
39. Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: executive summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132 Suppl. 2:S315-67.
40. Donnino MW, Andersen LW, Berg KM, Reynolds JC, Nolan JP, Morley PT, et al. Temperature management after cardiac arrest. Circulation. 2015;132:2448-56.
41. Patel TK, Patel PB, Barvaliya MJ, Tripathi CB. Drug-induced anaphylactic reactions in Indian population: a systematic review. Indian J Cri Care Med. 2014;18:796-806.
42. Morrison LJ, Gent LM, Lang E, Nunnally ME, Parker MJ, Callaway CW, et al. Part 2: evidence evaluation and management of conflicts of interest: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132 Suppl. 2:S368-82.
43. Kleinman ME, Brennan EE, Goldberger ZD, Swor RA, Terry M, Bobrow BJ, et al. Part 5: adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132 Suppl. 2:S414-35.
44. Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK, et al. Part 7: adult advanced cardiovascular life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132 Suppl. 2:S444-64.
45. Lavonas EJ, Drennan IR, Gabrielli A, Heffner AC, Hoyte CO, Orkin AM, et al. Part 10: special circumstances of resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S501-18.
46. Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015;95: 81-99.
47. Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 3. Adult advanced life support. Resuscitation. 2015;95:100-47.
48. Warren OJ, Alcock EMH, Choong AMTL, Leff DR, Van Herzeele I, Darzi AW, et al. Recombinant activated factor VII: a solution to refractory haemorrhage in vascular surgery? Eur J Vasc Endovasc Surg. 2008;35: 145-52.
49. Seifert PC, Peterson E, Graham K. Crisis management of fire in the OR. AORN J. 2015;101:250-63.
50. Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VRM, Deakin CD, et al. European resuscitation council and European society of intensive care medicine guidelines for post-resuscitation care 2015. Section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation. 2015;95: 202-22.
51. Truhlár A, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJLM, et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 4. Cardiac arrest in special circumstances. Resuscitation. 2015;95:148-201.
52. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115:827-48.
53. Girbes ARJ, Robert R, Marik PE. Protocols: help for improvement but beware of regression to the mean and mediocrity. Intensive Care Med. 2015;41:2218-20.
54. Rissmiller R. Patients are not airplanes and doctors are not pilots. Crit Care Med. 2006;34:2869, author reply 2869-70.
55. Kain ZN, Fitch JCK, Kirsch JR, Mets B, Pearl RG. Future of anesthesiology is perioperative medicine: a call for action. Anesthesiology. 2015;122:1192-5.
56. Borshoff D. The limitations of crisis checklists. Anesth Analg. 2014;118:1387-8.
Financiación Este estudio fue financiado por la Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.) y ejecutado por la el Instituto de Investigaciones Clínicas en asociación con el Grupo Revisor STI Cochrane de la Universidad Nacional de Colombia.
The publisher (Sociedad Colombiana de Anestesiología y Reanimación S.C.A.R.E.) retains copyright for the published articles.
Creative Commons License
Articles published by Colombian Journal of Anesthesiology are licensed under the Creative Commons 4.0 license: Attribution-NonCommercial-NoDerivs: CC BY-NC-ND.