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ACAD-AE-MED  January 2006

ACAD-AE-MED January 2006

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Subject:

Re: Simulators in Emergency Medicine Education

From:

Adrian Fogarty <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Thu, 19 Jan 2006 00:58:18 -0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (47 lines)

I was invited to observe an airway simulator training day last year. Very 
sophisticated, very elaborate set up, but very disappointing when it came to 
airway simulation. The day was designed more to foster 
leadership/communication/team management skills than anything else and fell 
short when it came to developing airway psychomotor skills. For example, 
they taught partial airway obstruction reasonably well, but total silent 
obstruction was ignored, yet it is more common and much more devastating. 
Apnoea was taught well but it should be a no-brainer when it comes to airway 
management, although in this case the student failed miserably to pick it 
up, partly as there was too much emphasis placed on watching monitors. They 
couldn't simulate laryngospasm at all; well, apart from the instructor 
making noises but they couldn't simulate the ventilatory effects which are 
the important ones. In short, you will learn much more about airway 
management in most anaesthetic lists than you will in current simulators.

Mind you, it didn't help that the guy running the unit was a professional 
"educator" who knew very little about airway management. He kept using terms 
like "the faculty" and "successfully completing the course" which struck me 
as rather bizarre for a voluntary postgraduate course aimed at adult 
learners. He appeared to have no working knowledge of anaesthetic drugs, 
preferring to fall back on simplistic dogma rather than consider rescue with 
neuromuscular blockade, which you must be prepared to do in certain 
situations, regardless of whether or not your manikin needs them! But to cap 
it all they taught oxygen failure very badly. Most of the "students" missed 
it as the "faculty" rather rigidly made them stick to ABC. You will always 
miss oxygen failure if you rigidly adhere to ABC, and I think they missed a 
golden opportunity there. So overall very disappointing. Not bad at 
team/crisis management but poor at simulating technical airway problems. You 
would be better off going to your local theatre list for a few days.

Adrian Fogarty


----- Original Message ----- 
From: "James McFetrich" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, January 18, 2006 4:27 PM
Subject: Simulators in Emergency Medicine Education

I would be interested to find out how anyone is using human patient 
simulators for training in EM, either at F2/SHO, SpR, Cons level, or nurse 
training etc.

I would be especially interested in anyone *not* using them specifically for 
anaesthetic type scenarios for airway management skills.

James

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