BACKGROUND: The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment. METHODS: The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council. A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios. The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured. RESULTS: The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR = 1.17, 95% CI: 1.02 to 1.35, p = 0.023) which were significantly more frequently performed in proper order (220: 338; OR = 1.68, 95% CI: 1.40 to 2.02, p < 0.0001). The use of ABCDE CAT did not prolong the time of patient assessment. CONCLUSION: The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.

Department of Anaesthesia and Intensive Care Medicine 3rd Faculty of Medicine CU and University Hospital Kralovske Vinohrady Charles University Prague Czech Republic

Department of Critical Care Medicine Children's Hospital of Philadelphia Philadelphia USA

Department of Internal Medicine Randers Regional Hospital Randers Denmark

Division of Public Health 3rd Faculty of Medicine Charles University Prague Prague Czech Republic

Emergency Department Motol University Hospital Prague Czech Republic

Emergency Department Skellefteå District General Hospital Skellefteå Sweden

Emergency Medical Services of Karlovy Vary Region Karlovy Vary Czech Republic

Emergency Medical Services of the Hradec Kralove Region Hradec Kralove Czech Republic

Emergency Medical Services of the Usti nad Labem Region Usti nad Labem Czech Republic

Faculty of Health Studies Jan Evangelista Purkyne University Usti nad Labem Czech Republic

Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove Charles University Prague Hradec Kralove Czech Republic

Medical College Prague Czech Republic

Prague Emergency Medical Services Prague Czech Republic

Research Center for Emergency Medicine Aarhus University Hospital Aarhus Denmark

Secondary Nursing School and Nursing College Prague Prague Czech Republic

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Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence