DOI: 10.1097/01.sa.0000119052.14209.75
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Issn Print: 0039-6206
Publication Date: 2004/04/01
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Excerpt
(Anesth Analg, 96:1739-1742, 2003)
*Department of Anesthesiology and Intensive Care, The Chaim Sheba Medical Center, Tel Hashomer, Israel; †The Israeli Center for Medical Simulation, The Chaim Sheba Medical Center, Tel Hashomer, Israel; ‡Department of Pediatric Critical Care, The Chaim Sheba Medical Center, Tel Hashomer, Israel. Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Training anesthesiologists to treat nerve gas intoxication in a mass casualty situation is complicated. The scenario involves an unfamiliar medical situation with the need to decontaminate patients before providing definitive medical treatment and the need for physical protection of the medical team before decontamination. The development of a simulation-based training program is described. In one site of a virtual hospital, anesthesiologists were trained in initial airway and breathing resuscitation before decontamination while wearing full protective gear. In another site, they were trained in the treatment of critically ill patients with combined conventional and chemical injuries or severe intoxication. Intubation simulators of newborn, pediatric, and adult patients, advanced full-scale simulators, and actors simulating patients were used. Initial airway, breathing, and antidotal treatment were performed successfully with or without full protective gear. The gas mask did not interfere with orotracheal intubation but limited effective communication within the medical team. Chemical protective gloves were the limiting factor in the performance of tasks such as fixing the orotracheal tube. Twenty-two (88%) participants thought that the simulated cases represented realistic problems in this scenario, and all 25 participants found the simulation-based training superior to previous traditional training they had received in this domain. Through the use of advanced simulation, researchers were able to train anesthesiologists to treat nerve gas intoxication casualties and to learn about the limitations of providing medical care in such a setting.
