Week 2

Question 1

What are the factors that couls effect decision making?

Answer 1

• Intrinsic Factors
• Extrinsic factors
• Bias
• Anchoring

Question 2

What is involved in Intrinsic factors

Answer 2

• Knowledge, experience, mood/psycology - fear, stress, fatigue

Question 3

What is involved in extrinsic factors

Answer 3

• Environment, information, protocols/rules, lone-working

Question 4

What is involved in Biases

Answer 4

• Confirmation bias, information bias, optimism bias

Question 5

What is involved in Anchoring

Answer 5

• Relying heavily on a single piece of information

Question 6

Why do we need decision making tools

Answer 6

• Reduce variability in triage or decision making
• Provide logical cues and memory aids in times of stress
• Rational vs Emotional
• Pre-frontal cortex vs Amygdala
• A link between intuitive and analytical decision making
  (Sandhu 2006)
• Standardise care for patients, reduce mistakes
• As a compliment not a substitute for clinical judgement

Question 7

Name the Tool Types

Answer 7

• Protocols
• Clinical Guidelines
• Algorithms
• Decision matrix
• NEWS, APGAR, GCS. Evidence based

Question 8

Define Protocols

Answer 8

• Rigid directions or set of predetermined criteria that determine the providers actions to manage specific presentations – evidence based

Question 9

Define Clinical Guidelines

Answer 9

• Recommends the care people should give for patients with specific conditions. UK Ambulance Service Clinical Practice Guidelines (AACE 2016), NICE, Resuscitation Council UK – best practice, evidence based. May include advice, prevention and long term management

Question 10

Define Algorithms

Answer 10

• a process or set of rules to be followed. Evidence based and can include patient data

Question 11

Define the Decision Matrix

Answer 11

• quantitative tool to rank/score options using set criteria to gain a total score

Question 12

Examples of Tools

Answer 12

• NICE Paediatric Traffic Light
• Trauma triage tool
• ALS protocol
• Sepsis 6 / care bundle
• FAST Acute stroke
• Ottawa ankle rules
• NEXUS / Canadian C-spine rules
• NEWS/PEWS/MEOWS
• GCS
• Manchester Triage Score
• Wells score
• Paramedic Pathfinder

Question 13

Some disadvantages to the using Tools

Answer 13

• Over-reliance – clouds clinical judgement
• Oversensitivity
• Not all tools suited to pre-hospital practice
  Lengthy, time consuming
  Evidence is for in-hospital patients
• Not all tools suited to all patients