Left Ventricular Assist Device Multialarm Emergency: A High-Fidelity Simulation Case for Emergency Medicine Residents.
| Autor: | Barnicle R; Clinical Instructor, Department of Emergency Medicine, Stony Brook University Hospital., Boaglio S; Clinical Instructor, Department of Emergency Medicine, Vanderbilt University Medical Center., Fitzgerald J; LVAD Coordinator, Department of Cardiothoracic Surgery, Stony Brook University Hospital., Otterness K; Assistant Residency Program Director, Department of Emergency Medicine, Stony Brook University Hospital., Johnson S; Residency Program Director, Department of Emergency Medicine, Stony Brook University Hospital., Ahn C; Assistant Residency Program Director, Department of Emergency Medicine, Stony Brook University Hospital. |
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| Jazyk: | angličtina |
| Zdroj: | MedEdPORTAL : the journal of teaching and learning resources [MedEdPORTAL] 2021 May 05; Vol. 17, pp. 11156. Date of Electronic Publication: 2021 May 05. |
| DOI: | 10.15766/mep_2374-8265.11156 |
| Abstrakt: | Introduction: As left ventricular assist devices (LVADs) become more prevalent in the treatment of patients with end-stage heart failure, emergency physicians must become experts in the management and resuscitation of patients with LVADs. As with other high-acuity, low-occurrence scenarios, managing the unstable LVAD patient makes for an ideal topic for simulation-based resident education. Methods: By incorporating a high-fidelity HeartMate 3 LVAD task trainer, our program developed and executed a novel LVAD simulation activity for our emergency medicine resident physicians. In the scenario, a 65-year-old male with recent LVAD placement arrived at a community hospital with undifferentiated hypotension. Various device alarms activated during the scenario and required intervention. Ultimately, the patient was found to be in septic/hypovolemic shock and only survived with appropriate resuscitation. We implemented a postscenario survey to assess the effectiveness of the simulation activity and administered it to 27 residents. Results: Content and delivery of our simulation were found to be effective; all survey questions regarding content and delivery obtained a mean score of 4.5 or greater on a 5-point Likert scale. Residents reported an overall high level of confidence in achieving most of the skill-based learning objectives (most scores > 4.1). The two objectives with the lowest confidence ratings were troubleshooting an LVAD and its various alarms (3.8) and demonstrating the ability to assess an LVAD patient (3.9). Discussion: Our LVAD simulation activity was successful and also revealed several potential areas for future research and simulation improvement. (© 2021 Barnicle et al.) |
| Databáze: | MEDLINE |
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