Aurora St. Luke's Medical Center, Department of Anesthesiology, Milwaukee, Wisconsin.
University of North Carolina, Department of Emergency Medicine, Chapel Hill, North Carolina.
West J Emerg Med. 2017 Jan;18(1):117-120. doi: 10.5811/westjem.2016.9.30891. Epub 2016 Nov 8.
We present a novel airway simulation tool that recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation.
We modified a standard difficult-airway mannequin head (Nasco, Ft. Atkinson, WI) with hardware-store equipment to enable simulation of vomiting or hemorrhage during intubation. A pre- and post-survey was used to assess the effectiveness of the SALAD simulator. We used a 1-5 Likert scale to assess confidence in managing the airway of a vomiting patient and comfort with suction techniques before and after the training exercise.
Forty learners participated in the simulation, including emergency physicians, anesthesiologists, paramedics, respiratory therapists, and registered nurses. The average Likert score of confidence in managing the airway of a vomiting or hemorrhaging patient pre-session was 3.10±0.49, and post-session 4.13±0.22. The average score of self-perceived skill with suction techniques in the airway scenario pre-session was 3.30±0.43, and post-session 4.03±0.26. The average score for usefulness of the session was 4.68±0.15, and the score for realism of the simulator was 4.65±0.17.
A training session with the SALAD simulator improved trainee's confidence in managing the airway of a vomiting or hemorrhaging patient. The SALAD simulation system recreates the dynamic challenges associated with emergency airways and holds promise as an airway training tool.
我们展示了一种新颖的气道模拟工具,可重现与紧急气道相关的动态挑战。抽吸辅助喉镜辅助去污(SALAD)模拟系统可培训医护人员使用抽吸来处理插管时出现的呕吐物和出血。
我们使用五金店的设备对标准困难气道模型头(Nasco,Ft. Atkinson,WI)进行了修改,以模拟插管期间的呕吐或出血。使用预调查和后调查来评估 SALAD 模拟器的有效性。我们使用 1-5 级 Likert 量表评估在接受培训之前和之后管理呕吐患者气道的信心以及对抽吸技术的舒适度。
共有 40 名学习者参加了模拟,包括急诊医师、麻醉师、护理人员、呼吸治疗师和注册护士。课前管理呕吐或出血患者气道的信心平均 Likert 评分为 3.10±0.49,课后为 4.13±0.22。课前气道场景中自我感知抽吸技术技能的平均评分为 3.30±0.43,课后为 4.03±0.26。课程有用性的平均评分为 4.68±0.15,模拟器的逼真度评分为 4.65±0.17。
SALAD 模拟器的培训课程提高了受训者管理呕吐或出血患者气道的信心。SALAD 模拟系统再现了与紧急气道相关的动态挑战,并有望成为气道培训工具。