Alinier Guillaume, Hassan Ibrahim Fawzy, Alsalemi Abdullah, Al Disi Mohammed, Ait Hssain Ali, Labib Ahmed, Alhomsi Yahya, Bensaali Fayçal, Amira Abbes, Ibrahim Abdulsalam Saif
1 Department of Research, Hamad Medical Corporation Ambulance Service, Medical City, Doha, Qatar & Simulation in Healthcare Education, School of Health and Social Work, Hatfield, Herts, UK.
2 Division of Critical Care, Medicine, Hamad General Hospital, Medical Intensive Care Unit, Doha, Qatar & Weill Cornell Medicine - Qatar, Doha, Qatar.
Perfusion. 2018 Oct;33(7):568-576. doi: 10.1177/0267659118777194. Epub 2018 May 23.
INTRODUCTION/AIM: The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants' suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations.
Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding.
A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change.
The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.
引言/目的:患者的病情以及体外膜肺氧合(ECMO)治疗的高风险性质促使临床服务机构确保临床医生接受适当培训,并随时准备有效应对危急情况。基于模拟的教育(SBE),从最简单的方法到最身临其境的模式,有助于促进最佳的个人和团队表现。SBE的风险包括负面学习、学习的不真实性以及过度依赖参与者的怀疑暂停。这对于ECMO SBE尤为相关,因为在不混淆回路改变的情况下,回路/患者之间的相互作用很难完全模拟。
我们致力于使ECMO模拟更简便、更逼真,以缩小目前SBE与实际ECMO患者护理之间的差距。需要克服的问题包括控制回路压力、系统故障、患者问题、血液颜色和成本因素。我们发展的关键是医院与大学的合作以及研究资金。
已开发出一种ECMO模拟器原型,可实现逼真的ECMO SBE。该系统模拟ECMO机器界面,具有可远程控制的压力参数、出血、管路颤动、气泡噪音和模拟的血液颜色变化。
该原型模拟器通过创新解决方案能够模拟常见的ECMO紧急情况,提高了ECMO SBE的逼真度,并减少了参与者对怀疑暂停的需求。未来的发展将涵盖患者插管方面。