Pediatric and Adult Anesthesiology Simulation Education: A Curriculum for Residents

318 Pages·2022·4.147 MB·English

by  Claire Sampankanpanich Soria (editor), Suraj Trivedi (editor)

Pediatric and Adult
Anesthesiology
Simulation Education
A Curriculum for Residents
Claire Sampankanpanich Soria
and Suraj Trivedi
Editors
123
Pediatric and Adult Anesthesiology Simulation
Education
Claire Sampankanpanich Soria • Suraj Trivedi
Editors
Pediatric and Adult
Anesthesiology Simulation
Education
A Curriculum for Residents
Editors
Claire Sampankanpanich Soria Suraj Trivedi
University of California, San Diego University of California, San Diego
Medical Center Medical Center
San Diego, CA, USA San Diego, CA, USA
ISBN 978-3-030-95337-9 ISBN 978-3-030-95338-6 (eBook)
https://doi.org/10.1007/978-3-030-95338-6
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Preface
Welcome to Pediatric and Adult Anesthesiology Simulation Education: A Curriculum
for Anesthesiology Residents. We decided to write this book after creating a new
simulation curriculum at the University of California San Diego for our anesthesiol-
ogy residents. As we created various adult and pediatric simulation cases, we real-
ized we could share our cases and help other programs either upgrade their current
list of simulation cases or start a new simulation program. We specifically included
pediatric case examples as these can be difficult to find.
The operating room environment has become more complex with technological
innovations. Successful outcomes depend on how well surgeons, anesthesiologists,
nurses, and techs collaborate and work together as a team. In the style of the dynamic
and fast-paced environment of the operating room, simulation training provides a
safe, interactive, and educational platform where anesthesia residents and staff can
enhance team performance.
The field of anesthesia has been a pioneer in the introduction of medical simula-
tion into medical education and training. The field of anesthesia is a hands-on spe-
cialty that requires dexterity and proficiency with important technical skills such as
advanced airway management, vascular access, neuraxial, and regional blocks [1].
Although the predominate use of simulation in anesthesia is to educate providers in
crisis management, it is also used to teach routine management and refresh skills [2].
We believe this book is unique because of the breadth of specialties covered,
including pediatric anesthesia. Pediatric anesthesia is a unique subspecialty within
the field of anesthesiology, with nuances due to variations in physiology and anat-
omy, as well as the potential for congenital diseases and syndromes not encountered
in daily practice of adult anesthesia. Our hope is that by providing a balance of adult
and pediatric anesthesia, this book can help anesthesiologists refresh their knowl-
edge and understanding of pediatric anesthesia and provide learners with an appre-
ciation for the subtleties and delicate care that must be given to pediatric patients.
This book is designed to be used by both academic programs and private practice
groups. We have divided the chapters into case-based formats with each chapter
containing a scenario layout, useful equipment, major teaching points for an after-
simulation debrief, and a learner evaluation form. This tiered education method will
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vi Preface
assist learners in working though essential team-building skills, increasing their
knowledge base, and finally having concrete items in which to further their profes-
sional skills.
Each chapter starts with a learning objective. The goals of the simulation are
made clear to the learner and the educator. A sample simulator environment setup is
then listed, with equipment, medications, and mannequin setup. Epps et al. has pro-
vided a list of mannequin-based simulation equipment and their setup [2]. We list
equipment that we recommend for the specific simulation case. However, we do
understand that depending on program preferences not every item may be available.
Generally, standard anesthesia airway supplies are readily available, and larger,
more specialized items such as defibrillator equipment can be either specially
acquired or improvised. We use the SimMan 3G plus © (Laerdal) mannequin which
enables us to remotely change vital signs and physical exam findings and allows
learners to practice procedures such as intubations and intravenous line placement.
However, an advanced mannequin or simulation lab is not a requirement to run a
successful simulation program, and often all that is required is a little creativity and
understanding.
Each chapter presents the simulation case before launching into the case progres-
sion, detailing how the simulated patient’s vital signs, physical exam findings, and
clinical picture change over the course of the simulation. There are several pathways
presented to the educator depending on what clinical choices the learner makes.
Each chapter has a master checklist of items the learner should accomplish during
the course of the simulation. We encourage educators to gently assist learners in
achieving these goals as these can be used for critical feedback at the end of a simu-
lation session. We close each chapter with a section summary and important teach-
ing points. In addition to the goals list, these often provide valuable educational
experiences to the learner.
San Diego, CA, USA Claire Sampankanpanich Soria
San Diego, CA, USA Suraj Trivedi
References
1. Green M, Tariq R, Green P. Improving patient safety through simulation training in anesthesi-
ology: where are we? Anesthesiol Res Pract. 2016;2016. doi:10.1155/2016/4237523.
2. Epps C, White ML, Tofil N. Mannequin based simulators. In: The comprehensive textbook of
healthcare simulation. Springer, New York; 2013:209–232. doi:10.1007/978-1-4614-5993-4_15.
Contents
1 Automatic Implantable Cardioverter Defibrillator (AICD)
Misfiring (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Claire Sampankanpanich Soria
2 Amniotic Fluid Embolism (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Claire Sampankanpanich Soria
3 Anaphylaxis (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Claire Sampankanpanich Soria
4 Anterior Mediastinal Mass (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . 25
Claire Sampankanpanich Soria
5 APNEA in Post-Anesthesia Care Unit (Adult) . . . . . . . . . . . . . . . . . . . 37
Claire Sampankanpanich Soria
6 Awake Tracheostomy (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Claire Sampankanpanich Soria
7 Brain Code (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Claire Sampankanpanich Soria
8 Bronchospasm (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Claire Sampankanpanich Soria
9 Burn Resuscitation (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Claire Sampankanpanich Soria
10 Button Battery Foreign Body (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . 79
Claire Sampankanpanich Soria
11 Code Sepsis (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Suraj Trivedi
12 Craniosynostosis (Pediatric). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Claire Sampankanpanich Soria
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13 Delivery Room Resuscitation (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . 111
Claire Sampankanpanich Soria
14 Difficult Airway in Obstetrics (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Claire Sampankanpanich Soria
15 Down Syndrome (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Claire Sampankanpanich Soria
16 Hematoma Post-Thyroidectomy (Adult) . . . . . . . . . . . . . . . . . . . . . . . . 137
Claire Sampankanpanich Soria
17 Hemothorax (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Claire Sampankanpanich Soria and Suraj Trivedi
18 Laryngospasm (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Claire Sampankanpanich Soria
19 Local Anesthetic Systemic Toxicity (Pediatric) . . . . . . . . . . . . . . . . . . 163
Claire Sampankanpanich Soria
20 Malignant Hyperthermia (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Claire Sampankanpanich Soria
21 Post-Fontan, Single Ventricle (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . 179
Claire Sampankanpanich Soria
22 Pyloric Stenosis (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Claire Sampankanpanich Soria
23 Status Epilepticus (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Claire Sampankanpanich Soria
24 Tetralogy of Fallot (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Claire Sampankanpanich Soria
25 Emergence Delirium (Pediatric) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Claire Sampankanpanich Soria
26 Venous Air Embolism (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Claire Sampankanpanich Soria
27 Chronic Obstructive Pulmonary Disease (Adult) . . . . . . . . . . . . . . . . 231
Suraj Trivedi, Matt Mueller, and Claire Sampankanpanich Soria
28 Disseminated Intravascular Coagulation (Adult) . . . . . . . . . . . . . . . . 239
Suraj Trivedi, Matt Mueller, and Claire Sampankanpanich Soria
29 Severe Aortic Stenosis (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Suraj Trivedi, Matt Mueller, and Claire Sampankanpanich Soria
30 Extracorporeal Membrane Oxygenation (Adult) . . . . . . . . . . . . . . . . 253
Suraj Trivedi and Matt Mueller
Contents ix
31 Transfusion Reaction (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Suraj Trivedi, Matt Mueller, and Claire Sampankanpanich Soria
32 Pulmonary Hypertension (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Suraj Trivedi, Matt Mueller, and Claire Sampankanpanich Soria
33 Awareness Under Anesthesia (Adult) . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Minh Tran, Michael Paluy, and Claire Sampankanpanich Soria
34 Seizure During an Awake Craniotomy (Adult) . . . . . . . . . . . . . . . . . . 291
Minh Tran and Merrick Tan
35 Out of Operating Room Considerations
and Neurointerventional Radiology (Adult) . . . . . . . . . . . . . . . . . . . . . 299
Minh Tran and Merrick Tan
36 Epiglottitis (Pediatric). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Claire Sampankanpanich Soria and Phil Yao
37 Neonatal Abdominal Wall Defects (Pediatric) . . . . . . . . . . . . . . . . . . . 315
Claire Sampankanpanich Soria and Phil Yao
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Contributors
Matt  Mueller University of California, San Diego Medical Center, San
Diego, CA, USA
Michael  Paluy University of California, San Diego Medical Center, San
Diego, CA, USA
Claire Sampankanpanich Soria University of California, San Diego Medical
Center, San Diego, CA, USA
Merrick  Tan University of California, San Diego Medical Center, San
Diego, CA, USA
Minh  Tran University of California, San Diego Medical Center, San
Diego, CA, USA
Suraj  Trivedi University of California, San Diego Medical Center, San
Diego, CA, USA
Phil Yao University of California, San Diego Medical Center, San Diego, CA, USA
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