I’ve come to develop some strong opinions on the utility of cognitive aids in emergencies. Most of this is evidence based rather than my internal crazy:

• Having a ‘reader’ is vital. This dictated the design of the aid. It should have a linear flow to allow non-anaesthetists to read it easily. Flow charts are hard/impossible to describe across a room.
• Algorithms are designed to be used as a reference and are not that useful in a crisis. They are also generally not localised to theatre or anaesthetics. 
• People must be familiar with an aid before needing to use it in a crisis. This also dictates the benefit/need of a universal design theme for an aid in a crisis. There is great advantage in every page being laid out the same. People know how the aid works, and thus how to use it. Learn the theme of one page, learn them all
• Drug calculations in an emergency are littered with error. Infusion calculations are an absolute disaster. It is imperative these tasks are ‘offload-able’ in a crisis. Thus these should be laid out as for a non-anaesthetist to do.
• Main priorities should be spelled out early i.e. first!

Other things suggested by the experts in the literature:

• Content should be derived from best practise guidelines
• It must be localised and simple. 
• it must assist other team members
• it should be reviewed by local experts and updated as guidelines changed. 

These opinions dictated the design choices in this manual:

• Its bright & bold. So use it.
• Instruction pages at the front to guide people on how to use the book & best practise in a crisis.
• Encouragement to utilise the reader role
• In fact the book has been designed around the reader role:
  • List based design. Read from top to bottom
  • Words & phrases which are easy to read & hopefully non-doctors can understand
  • No algorithms found in the book
• Drug calculations pre done based on 70kg person. Infusions are kept simple by stating what to put in what and dose range in mls/hr to run at (to enable you to offload setup to a non-anaesthetist if required)
• Quick reference index page & tabs for quick navigation
• Same design on each page. Red section = emergency tasks. Yellow section = thinking tasks or further info. Green section = drug doses or equipment calculations
• Lots of visual aids – bolded words, highlighted decision points, all drugs in bold green
• Comprehensive drug formulary for adults & children

And much more….