Document Detail


High-fidelity medical simulation as an assessment tool for pediatric residents' airway management skills.
MedLine Citation:
PMID:  17228214     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate high-fidelity medical simulation as an assessment tool for pediatric residents' ability to manage an acute airway. METHODS: We performed a prospective, observational study in which 16 pediatric residents were consented and then brought to the medical simulation center. They were placed in 2 different computer-driven scenarios and asked to manage the cases. The first scenario was a 3-month-old infant with bronchiolitis and severe respiratory distress and was programmed to develop respiratory failure. The second case was a 16-year-old adolescent with alcohol intoxication and respiratory depression and was programmed for emesis and aspiration. Both cases included a nurse, parent, and intern. We recorded performance of predetermined critical actions and any harmful actions. RESULTS: There were 47 attempts at intubation with 27 successes (56%). Appropriate preoxygenation was performed in 15 (47%) of 32 cases. Appropriate rapid sequence induction was administered in 21 (66%) of 32 cases. Cricoid pressure was applied in 20 (63%) of 32 cases. End-tidal carbon dioxide detector was used in 11 (34%) of 32 cases. A nasogastric tube was placed in 14 (44%) of 32 cases. Harmful actions included rapid sequence induction administered before intubation equipment setup, bag-valve mask not connected to oxygen, inappropriate endotracheal tube size, pulling cuffed endotracheal tube out while inflated, and placing the laryngoscope blade on backwards. CONCLUSIONS: Our data identified many areas of concern with resident skills in managing an airway. This project suggests that high-fidelity medical simulation can assess a resident's ability to manage an airway as well as a program's effectiveness in teaching the skills necessary to manage an acute pediatric airway.
Authors:
Frank L Overly; Stephanie N Sudikoff; Marc J Shapiro
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  23     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-17     Completed Date:  2007-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-5     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Rhode Island Hospital, Providence, RI 02903, USA. foverly@lifespan.org
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence*
Computer Simulation
Humans
Internship and Residency*
Intubation, Intratracheal / standards*
Patient Simulation*
Pediatrics / education*
Prospective Studies
Respiratory Tract Diseases / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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