Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration
Abstract Introduction More than half of pregnancies experienced by U.S. women are unintended, one in five ends in miscarriage, and one in four ends in abortion. Uterine aspiration is a procedure used to manage miscarriage or incomplete or therapeutic abortion. Because complications of uterine aspira...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2015-12-01
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| Series: | MedEdPORTAL |
| Subjects: | |
| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10296 |
| _version_ | 1818964413917429760 |
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| author | Suzan Goodman Sarah McNeil Grace Shih |
| author_facet | Suzan Goodman Sarah McNeil Grace Shih |
| author_sort | Suzan Goodman |
| collection | DOAJ |
| description | Abstract Introduction More than half of pregnancies experienced by U.S. women are unintended, one in five ends in miscarriage, and one in four ends in abortion. Uterine aspiration is a procedure used to manage miscarriage or incomplete or therapeutic abortion. Because complications of uterine aspiration are rare, trainees may benefit from supplemental complication training. To practice managing hemorrhage as a complication of uterine hemorrhage, this training module uses a fruit (i.e., pitaya/dragonfruit) model for practicing hands-on skills, cases, and a helpful mnemonic (6 Ts) for learning causes and management steps. Methods The instructor uses the provided PowerPoint to review safety, potential risks, and complications of uterine aspiration. Next, the instructor undertakes fishbowl demonstration of uterine aspiration using a case complicated by hemorrhage. An interactive brainstorm helps review causes and management steps for hemorrhage, using the 6 Ts mnemonic for causes (i.e., tissue, tone, trauma, and thrombin) and management (i.e., transfer, treatment) of bleeding. Next, learners split into groups of three (provider, assistant, and evaluator) so each can practice and be evaluated on integration of all management steps. The larger group then reunites to discuss pitfalls and keys for integration into clinical settings. Results We evaluated the workshop among a group of medical and nursing professionals with varied uterine aspiration experience. A total of 46 learners participated in the trainings and session evaluations. Knowledge scores improved from pre− to posttest, with a mean overall improvement of 9%. Further, 19 participants were asked additional questions following the training. The majority agreed that the simulation helped prepare them for specific skills of cannula test (94%), uterine tamponade with foley (94%), and assessment of the cervix for bleeding (83%). Discussion Given the fact that complications of uterine aspiration are rare, trainees will benefit from this supplemental complication training. Compared to sophisticated models, this simulation is inexpensive and materials are easily attainable in most parts of the world. Pitaya fruit simulates both the grittiness of the uterus after aspiration, pliability of uterine involution, and those varieties with red pulp nicely simulate bleeding (although red food dye can also be added to saline). If pitaya is seasonally unavailable, papaya can also be substituted. |
| first_indexed | 2024-12-20T13:00:43Z |
| format | Article |
| id | doaj.art-80838388061c4e6baae08b1220c435e2 |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-20T13:00:43Z |
| publishDate | 2015-12-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-80838388061c4e6baae08b1220c435e22022-12-21T19:39:55ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652015-12-011110.15766/mep_2374-8265.10296Simulation for Managing Hemorrhage as a Complication of Uterine AspirationSuzan Goodman0Sarah McNeil1Grace Shih21 University of California, San Francisco2 Contra Costa Regional3 University of Washington School of MedicineAbstract Introduction More than half of pregnancies experienced by U.S. women are unintended, one in five ends in miscarriage, and one in four ends in abortion. Uterine aspiration is a procedure used to manage miscarriage or incomplete or therapeutic abortion. Because complications of uterine aspiration are rare, trainees may benefit from supplemental complication training. To practice managing hemorrhage as a complication of uterine hemorrhage, this training module uses a fruit (i.e., pitaya/dragonfruit) model for practicing hands-on skills, cases, and a helpful mnemonic (6 Ts) for learning causes and management steps. Methods The instructor uses the provided PowerPoint to review safety, potential risks, and complications of uterine aspiration. Next, the instructor undertakes fishbowl demonstration of uterine aspiration using a case complicated by hemorrhage. An interactive brainstorm helps review causes and management steps for hemorrhage, using the 6 Ts mnemonic for causes (i.e., tissue, tone, trauma, and thrombin) and management (i.e., transfer, treatment) of bleeding. Next, learners split into groups of three (provider, assistant, and evaluator) so each can practice and be evaluated on integration of all management steps. The larger group then reunites to discuss pitfalls and keys for integration into clinical settings. Results We evaluated the workshop among a group of medical and nursing professionals with varied uterine aspiration experience. A total of 46 learners participated in the trainings and session evaluations. Knowledge scores improved from pre− to posttest, with a mean overall improvement of 9%. Further, 19 participants were asked additional questions following the training. The majority agreed that the simulation helped prepare them for specific skills of cannula test (94%), uterine tamponade with foley (94%), and assessment of the cervix for bleeding (83%). Discussion Given the fact that complications of uterine aspiration are rare, trainees will benefit from this supplemental complication training. Compared to sophisticated models, this simulation is inexpensive and materials are easily attainable in most parts of the world. Pitaya fruit simulates both the grittiness of the uterus after aspiration, pliability of uterine involution, and those varieties with red pulp nicely simulate bleeding (although red food dye can also be added to saline). If pitaya is seasonally unavailable, papaya can also be substituted.http://www.mededportal.org/doi/10.15766/mep_2374-8265.10296AbortionHemorrhageUterine AspirationPapayaBleedingComplication |
| spellingShingle | Suzan Goodman Sarah McNeil Grace Shih Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration MedEdPORTAL Abortion Hemorrhage Uterine Aspiration Papaya Bleeding Complication |
| title | Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration |
| title_full | Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration |
| title_fullStr | Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration |
| title_full_unstemmed | Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration |
| title_short | Simulation for Managing Hemorrhage as a Complication of Uterine Aspiration |
| title_sort | simulation for managing hemorrhage as a complication of uterine aspiration |
| topic | Abortion Hemorrhage Uterine Aspiration Papaya Bleeding Complication |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10296 |
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