The RNSH AnaeSthesia Cognitive Aid Research Group (ASCAR)

Anaesthetic crises are fortunately rare. It is perhaps exactly for this reason that using cognitive aids to troubleshoot these scenarios is so vital.

These emergencies are replete with ever-changing priorities, unfamiliar interventions and challenging team dynamics. Having ready access to well designed cognitive aids can help us perform under this type of duress, with it being increasingly recognised that their use forms a pivotal part of effective Crisis Resource Management.

ASCAR is involved in designing aids to support anaesthetists of all levels in the management of these crises by utilising a unique first-in-kind double-sided ‘front-back’ formula. The ‘fronts’ are designed to offer operators a concise, distilled and visually appealing framework to respond in the initial moments of a crisis. They are intentionally lacking in the detail encountered in other aids in order to specifically highlight the key interventions and priorities that typically get overlooked during the catecholamine surge. The ‘backs’ on the other-hand are designed to be used once the ‘cavalry’ arrive, by offering larger teams a more comprehensive, linear and contextualised guide that is more suited to a scenario in which there are multiple hands available.

This side of the aids will often offer explanations and provide options where they exist. Incidentally, these ‘backs’ therefore also serve as useful educational tools to reflect upon these rare scenarios ahead of cases or during periods of lower acuity. We hope they will also form a valuable resource to those attempting the ANZCA part 2 examination. The aids are most certainly not designed to be a ‘how-to’ recipe book for novices but rather, their aim is to allow expert teams to perform at their best in the pursuit of clinical excellence.

It should also be recognised that in their present form, these aids are specifically tailored to practice at Royal North Shore accounting for the ergonomics, surgical expertise and culture that we are fortunate to be a part of. We look forward to integrating these tools into a wider program of anaesthesia simulation and training in the near future and are currently looking at tool validation and research.

The below is a preview of the first ASCAR Neuroanaesthetic crisis manual

For enquiries, please contact RNS-ASCAR@gmail.com