Michelet Daphné, Truchot Jennifer, Piot Marie-Aude, Drummond David, Ceccaldi Pierre-François, Plaisance Patrick, Tesnière Antoine, Dahmani Souhayl
Ilumens Simulation Department, University Paris Descartes, Paris, France.
Department of Anesthesia, Robert Debré Hospital, Paris, France.
BMJ Simul Technol Enhanc Learn. 2018 Sep 26;5(3):161-166. doi: 10.1136/bmjstel-2018-000364. eCollection 2019.
Paediatric anaesthesia is a very specialised domain lacking training during the traditional curriculum. The laryngospasm is a stressful and life-threatening event that requires immediate action. The main objective of this study was to assess the effect of knowledge of a simple algorithm on the management of laryngospasm by trainee anaesthetists and nurse anaesthetists during a high-fidelity simulation session.
Residents in paediatric anaesthesia and training nurse anaesthetists with similar curriculum were randomly allocated to undergo a simulation session of laryngospasm with the help of a simple algorithm administered to them 5 min before the simulation session (group A) or as taught in their curriculum (group C). The primary endpoint was the assessment score of laryngospasm management using 10 technical items (validated in experienced paediatric anaesthetists). Secondary endpoints were: the non-technical skills using the Anaesthetists' Non-Technical Skills (ANTS) score and timing of critical management steps. The correlation between the technical and non-technical scores was also studied. Data are expressed as median (range).
72 participants (18 teams in each group) were included in this study. There was a statistically significant difference between group A and C on the primary endpoint: 8.5 (2-10) vs 5 (2-8), respectively (p<0.0001). There was also a significant difference between the two groups for the ANTS score 12 (7-16) vs 8 (6-12), respectively (p<0.0001). No difference in timing of management was observed. Finally, there was a strong correlation between the technical skills and all the non-technical skills categories in the A group.
A simple algorithm improved the technical and non-technical skills of students during the management of a simulated laryngospasm.
儿科麻醉是一个非常专业的领域，在传统课程中缺乏相关培训。喉痉挛是一种压力大且危及生命的事件，需要立即采取行动。本研究的主要目的是评估一种简单算法的知识对实习麻醉医师和麻醉护士在高仿真模拟训练中处理喉痉挛的效果。
儿科麻醉住院医师和接受类似课程培训的麻醉护士被随机分配，在模拟训练前5分钟接受一个简单算法的指导（A组），或按照他们课程中教授的方法（C组），进行喉痉挛模拟训练。主要终点是使用10项技术指标（在有经验的儿科麻醉医师中验证过）对喉痉挛处理的评估得分。次要终点包括：使用麻醉医师非技术技能（ANTS）评分评估非技术技能以及关键处理步骤的时间。还研究了技术得分与非技术得分之间的相关性。数据以中位数（范围）表示。
本研究纳入了72名参与者（每组18个团队）。A组和C组在主要终点上存在统计学显著差异：分别为8.5（2 - 10）和5（2 - 8）（p<0.0001）。两组在ANTS评分上也存在显著差异，分别为12（7 - 16）和8（6 - 12）（p<0.0001）。未观察到处理时间上的差异。最后，A组的技术技能与所有非技术技能类别之间存在强相关性。
一种简单算法在模拟喉痉挛处理过程中提高了学生的技术和非技术技能。
