Team Training: Unanticipated Difficult Airway

Abstract Introduction This is a team-based simulation resource using a SimMan. The resource is designed to expose junior and senior anesthesia residents to a “cannot intubate, cannot ventilate” scenario after a failed spinal anesthetic. Through this experience learners are provided an opportunity to...

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Main Authors: Stefan Lombaard, Julia Metzner, Brian Ross, Sara Kim, Megan Sherman
Format: Article
Language:English
Published: Association of American Medical Colleges 2008-10-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.1654
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author Stefan Lombaard
Julia Metzner
Brian Ross
Sara Kim
Megan Sherman
author_facet Stefan Lombaard
Julia Metzner
Brian Ross
Sara Kim
Megan Sherman
author_sort Stefan Lombaard
collection DOAJ
description Abstract Introduction This is a team-based simulation resource using a SimMan. The resource is designed to expose junior and senior anesthesia residents to a “cannot intubate, cannot ventilate” scenario after a failed spinal anesthetic. Through this experience learners are provided an opportunity to manage a life-threatening airway emergency that plays out in real time, where the correct steps need to be taken in a limited amount of time. Methods This 2-hour session includes a briefing prior to the simulation, the simulation session, and a postsession debriefing. During the session a junior anesthesia resident performs a spinal anesthetic and manages conscious sedation. A senior anesthesia resident manages the situation as an unanticipated difficult airway scenario develops. As this scenario unfolds the team will need to evaluate the preoperative airway. The team will need to recognize the need to call for assistance early in the event, utilize various alternative techniques for airway management, and optimize resource management skills. Results We have used this simulation scenario a total of nine times and a total of 24 residents in two- or three-person groups have participated. The feedback we have received has been very favorable. Discussion This scenario exposes residents to a critical situation which they are likely to encounter during their career as anesthesiologists. This allows them to be able to put theoretical knowledge in practice in a crisis. Errors we observed in the simulator correlated with errors reported to continuous quality improvement. We have found that occasionally residents would fail to follow the American Society of Anesthesiologists guidelines in a crises situation even if they are familiar with these guidelines. The residents tended to “suspend disbelief” and become more involved with the scenario when the simulator responded in a believable way; for instance responding to the oxygen mask being placed over his face.
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spelling doaj.art-48f74b8104cd446c8ff878fd92bfb3932022-12-21T22:50:41ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652008-10-01410.15766/mep_2374-8265.1654Team Training: Unanticipated Difficult AirwayStefan Lombaard0Julia Metzner1Brian Ross2Sara Kim3Megan Sherman41 University of Washington School of Medicine2 University of Washington School of Medicine3 University of Washington School of Medicine4 University of Washington School of Medicine5 University of Washington School of MedicineAbstract Introduction This is a team-based simulation resource using a SimMan. The resource is designed to expose junior and senior anesthesia residents to a “cannot intubate, cannot ventilate” scenario after a failed spinal anesthetic. Through this experience learners are provided an opportunity to manage a life-threatening airway emergency that plays out in real time, where the correct steps need to be taken in a limited amount of time. Methods This 2-hour session includes a briefing prior to the simulation, the simulation session, and a postsession debriefing. During the session a junior anesthesia resident performs a spinal anesthetic and manages conscious sedation. A senior anesthesia resident manages the situation as an unanticipated difficult airway scenario develops. As this scenario unfolds the team will need to evaluate the preoperative airway. The team will need to recognize the need to call for assistance early in the event, utilize various alternative techniques for airway management, and optimize resource management skills. Results We have used this simulation scenario a total of nine times and a total of 24 residents in two- or three-person groups have participated. The feedback we have received has been very favorable. Discussion This scenario exposes residents to a critical situation which they are likely to encounter during their career as anesthesiologists. This allows them to be able to put theoretical knowledge in practice in a crisis. Errors we observed in the simulator correlated with errors reported to continuous quality improvement. We have found that occasionally residents would fail to follow the American Society of Anesthesiologists guidelines in a crises situation even if they are familiar with these guidelines. The residents tended to “suspend disbelief” and become more involved with the scenario when the simulator responded in a believable way; for instance responding to the oxygen mask being placed over his face.http://www.mededportal.org/doi/10.15766/mep_2374-8265.1654AnesthesiaIntubationAirway ObstructionPulmonary VentilationSpinalIntrathecal
spellingShingle Stefan Lombaard
Julia Metzner
Brian Ross
Sara Kim
Megan Sherman
Team Training: Unanticipated Difficult Airway
MedEdPORTAL
Anesthesia
Intubation
Airway Obstruction
Pulmonary Ventilation
Spinal
Intrathecal
title Team Training: Unanticipated Difficult Airway
title_full Team Training: Unanticipated Difficult Airway
title_fullStr Team Training: Unanticipated Difficult Airway
title_full_unstemmed Team Training: Unanticipated Difficult Airway
title_short Team Training: Unanticipated Difficult Airway
title_sort team training unanticipated difficult airway
topic Anesthesia
Intubation
Airway Obstruction
Pulmonary Ventilation
Spinal
Intrathecal
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.1654
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