Blog: Emergency Manual Implementation Collaborative

March 10, 2015

It takes approximately 10,000 hours of practice for a skill to be ingrained in your memory. As such, none of us can be experts in delivering all of the management tools necessary during a critical event with a patient. Distractions in an emergency can also prevent knowledge from transferring from our brains to the patient in need.

Cognitive aids have long been used by the aviation industry to increase safety and performance in an emergency situation. Medical simulation studies show that integrating cognitive aids in to the operating room has a similar positive impact on patient safety and care. During a critical event, our memory decreases due to the stressors of the environment. Cognitive aids help shift the focus from the distractions back to the task at hand.

Encompass Medical Partners’ (EMP) EQUIP team has implemented an emergency manual collaborative with Poudre Valley Hospital and Medical Center of the Rockies. As a result of the collaborative, cognitive aids for perioperative events created by Stanford University have been distributed to the operating rooms of both hospitals. Christopher Elmore, CRNA, MBA who is the Project Manager for EMP’s Quality Improvement Program, has been working on‐site with local physician champions to train, educate, and answer questions about the manuals.

The red manuals are displayed in visible locations within the operating rooms, in addition to PDF and mobile app versions available for download. Critical events covered within the manual include Anaphylaxis, Power Failure, Malignant Hyperthermia, and Local Anesthetic Toxicity. In addition to assisting in everyday emergencies, cognitive aids are a useful tool in training for MOCA simulations. Critical events are not an everyday occurrence.


The cognitive aid manuals help clinicians deliver the best possible care during medical emergencies. To download an emergency manual as a PDF or on your smartphone, visit:

To learn more about why and how to implement emergency manuals, watch this informative video from the Stanford Emergency Manual’s website:

This video demonstrates the use of a cognitive aid and a crisis checklist during a case. The team uses the checklists to communicate efficiently and provide quality of care to the patient:

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