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Why simulation training matters

Simulation training helps clinicians to maintain their skills and to provide life-saving care with confidence.

Simulation training helps clinicians to maintain their skills and to provide life-saving care with confidence.

In a workplace emergency I was able to competently and confidently provide airway ventilation to a patient in cardiac arrest. Why? Because I’d practised for such an eventuality during simulation training.

resus nursing
Simulation training can give practitioners a greater set of skills
Picture: iStock

The patient was an older woman who had been admitted with dehydration secondary to diarrhoea and vomiting. Initial investigations revealed that she had hypokalaemia and hypomagnesaemia, which were both suggested as the cause.

I realised that the on-call medical registrar and I were the most senior clinicians, and I stated that I would manage the patient’s airway.

I identified an obstruction. This was expected, as people who need resuscitation often have an obstructed airway, usually caused by loss of consciousness (Resuscitation Council (UK) 2016).

Effectiveness

I provided prompt airway management; crucial to help prevent secondary hypoxic damage to the brain and vital organs (Resuscitation Council 2016). I decided to insert an airway, while chest compressions were maintained, to enable more effective ventilation compared with the use of basic airway adjuncts, and also to reduce the risk of gastric inflation (Resuscitation Council (UK) 2016).

After defibrillation attempts for ventricular fibrillation, the patient had a return of spontaneous circulation. I initially supported ventilation, but the patient quickly started to make respiratory effort and began breathing adequately and independently.

An anaesthetist attended as part of the medical emergency team, made sure I was managing the patient’s airway effectively and allowed me to continue. After ten minutes, the patient became increasingly responsive, began to bite on the airway, then began to gag.

I removed the airway, reassessed the patient and saw that an airway device was no longer needed. The patient was transferred to the intensive care unit for further care.

Independent management

Despite qualifying in 2002, this was the first time I had independently managed a patient’s airway with a supraglottic device. Yet I felt competent to perform the skill due to regular training on courses accredited by the Resuscitation Council (UK) such as immediate life support and advanced life support. 

I recertified in the advanced life support course in June 2016 using scenario-based simulations on realistic training aids, using the actual airway devices available in practice.

Over the past two decades, there has been an enthusiastic adoption of simulation in healthcare education. It has been recognised as an opportunity to practise and hone skills in a controlled environment (Motola et al 2013).

I believe it to be very relevant to healthcare today to improve patient safety and care (Gaba 2007).

The advanced course included workshops, skill stations and cardiac arrest simulations. I had never actually inserted that type of airway in practice, but I had trained extensively in clinical simulations and this is one of the strengths of training.

The scenarios let practitioners replicate real situations to provide prompt, safe and effective airway management. This experience has demonstrated to me the life-saving benefits that simulation training can deliver. 


References

  • Gaba D (2007) The future vision of simulation in healthcare. Journal of the Society for Simulation in Healthcare. 2, 2,126-135.
  • Motola I, Devine L, Chung H (2013) Simulation in healthcare education: a best evidence practical guide. AMEE Guide No 82. Medical Teacher. 35, 10, e1511-1530.
  • Resuscitation Council (UK) (2016) Advanced Life Support. Seventh edition. RCUK, London

About the author

Neal Aplin

Neal Aplin is an advanced nurse practitioner at Great Western Hospital, Swindon

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