Bringing ultrasound into multi-disciplinary emergency scenarios

The simulation suite at the University Hospital of South Manchester recently piloted a course aimed at developing and improving how emergencies are managed in cardiac catheter labs and exploring if team training, through a programme of workshops and simulation would be beneficial. Using the HeartWorks TTE mobile simulator, the new Catheter Lab Emergency Management Simulation (CLEMS) course is one of the first to incorporate echocardiography into emergency scenario simulations.

“Multi-disciplinary team training is not new in simulation, but focusing on crisis management scenarios unique to the catheter Lab environment is something we were keen to explore”, said Dr. Tim Strang, Consultant Anaesthetist at the University Hospital of South Manchester.

 Supporting patient safety initiatives

Referencing the WHO (World Health Organization) Surgical Safety Checklist initiative, Dr. Strang continued, ‘One of the principal aims of the course is to instil a culture of patient safety into team performance. The introduction of role allocations and pre-briefing checklists aims to change team perspectives allowing them to work more effectively and efficiently to maximise support for the operating cardiologist.’

 Preparation is vital for effective crisis management

Dr. Lisa Wee, Simulation Fellow at the Univeristy Hospital of South Manchester, who helped design the course describes one of the scenarios facilitated by the HeartWorks simulator –  A deteriorating patient with left ventricular failure in the recovery room.  ‘We used this scenario so that the team members could test their planned emergency response from their earlier briefing. The team which comprised a cardiology registrar, two nurses, a radiographer and a cardiac physiologist undertook a team briefing, and assigned roles in the event of a deterioration in the patients condition. As a result of their preparation, the team’s management of the situation became one of time efficient and well ordered management as they shifted their focus to the more urgent needs of the patient’s deteriorating condition which could have led to an arrest. Each of the team members’ responses were delivered in a time-critical, co-ordinated, efficient and calm manner. We believe that this type of training is important in our efforts to improve patient outcomes in similar emergencies.’

 Making it real!

Commenting on the use of the HeartWorks simulator, Dr. Wee said, ‘It greatly enhanced the fidelity of this scenario. When running emergency simulations, you want them as close to the real thing as possible to promote suspended disbelief for the participants. The use of ultrasound in this scenario was key for the team to determine appropriate diagnosis and treatment. The HeartWorks TTE Mobile simulator which we fitted over our full body manikin allowed us to incorporate these skills realistically and seamlessly within the overall scenario.’

CLEMS is a two day course featuring a variety of workshops and training scenarios and has been designed by an inter-professional team including cardiologists, cardiac physiologists, nurses, radiologists and simulation members. For further information, contact Mike Smith (Simulation Manager, University Hospital of South Manchester) on 0161 2915930.