开发和测试一种用于紧急脐静脉导管插入模拟训练的混合模拟器。
Development and Testing of a Hybrid Simulator for Emergent Umbilical Vein Catheter Insertion Simulation Training.
机构信息
From the ABS Lab Q.C., C.B., D.O.), Anatomy Biomechanics Simulation Laboratory, Faculty of Medicine, University of Poitiers, Poitiers; Emergency Department, Trauma Center, and EMS (D.A.G.), University Hospital of Amiens, Amiens; and Neonatal and Pediatric Intensive Care Unit (Q.C.), and Pediatric Emergency Department (D.O.), University Hospital, Poitiers, France.
出版信息
Simul Healthc. 2023 Oct 1;18(5):333-340. doi: 10.1097/SIH.0000000000000700. Epub 2022 Nov 8.
INTRODUCTION
Emergent umbilical venous catheter (eUVC) insertion is the recommended vascular access in neonatal resuscitation. Although the theoretical knowledge can be taught, existing models are either unrealistic (plastic) or train only the steps of the task. This study aimed to develop and test a hybrid simulator for eUVC insertion training that would be realistic, reproducible, easy to build, and inexpensive, thereby facilitating detailed learning of the procedure.
METHODS
Development took place in the Poitiers simulation laboratory using a neonatal mannequin into which a real umbilical cord was integrated. In the first phase, pediatric and emergency physicians and residents tested the model. In the second phase, another group of participants tested the hybrid simulator and the same neonatal mannequin associated with an artificial umbilical cord. Participants completed a satisfaction survey.
RESULTS
A real umbilical cord connected to an intra-abdominal reservoir containing artificial blood was added to the mannequin, allowing insertion of the eUVC, drawback of blood, and infusion of fluids using the real anatomical structures. The model was easily reproduced and assembled in less than 30 minutes; the cost of construction and use was evaluated at €115. One hundred two participants tested the model, 60 in the first phase and 42 in the second. The success rate was higher in fully trained compared with untrained participants. All were satisfied, 97% found the model realistic, and 78.6% strongly recommended the use of this model. The participants believed that the hybrid simulator allowed better learning and a gain in performance and self-confidence in comparison with the same mannequin with an artificial umbilical cord.
CONCLUSIONS
A hybrid simulator was developed for eUVC insertion. Participants were satisfied with this model, which was realistic, reproducible, easy to use, inexpensive, and facilitated an understanding of the anatomy and performance of all steps for successful eUVC insertion.
简介
紧急脐静脉导管（eUVC）插入术是新生儿复苏中推荐的血管通路。虽然可以教授理论知识，但现有的模型要么不切实际（塑料模型），要么只训练任务的步骤。本研究旨在开发和测试一种用于 eUVC 插入训练的混合模拟器，该模拟器具有逼真、可重复、易于构建且价格低廉的特点，从而便于详细学习该程序。
方法
开发工作在普瓦捷模拟实验室进行，使用了一个新生儿模型，其中集成了一根真实的脐带。在第一阶段，儿科和急诊医生以及住院医师测试了该模型。在第二阶段，另一组参与者测试了混合模拟器和同一具有人造脐带的新生儿模型。参与者完成了一份满意度调查。
结果
在模型中添加了一根连接到含有人造血液的腹腔储液器的真实脐带，允许进行 eUVC 插入、血液回抽以及使用真实解剖结构进行液体输注。该模型易于复制和组装，不到 30 分钟即可完成；建造和使用的成本评估为 115 欧元。共有 102 名参与者测试了该模型，其中 60 名在第一阶段，42 名在第二阶段。经过充分培训的参与者的成功率高于未经培训的参与者。所有参与者都满意，97%的人认为模型逼真，78.6%的人强烈推荐使用该模型。参与者认为，与具有人造脐带的相同模型相比，混合模拟器可以更好地学习，提高性能和自信。
结论
为 eUVC 插入开发了一种混合模拟器。参与者对该模型感到满意，该模型具有逼真、可重复、易于使用、价格低廉的特点，有助于理解成功进行 eUVC 插入所需的所有步骤的解剖结构和性能。
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