Traditional Poster Round
Context: : Anaesthetic emergencies are rare in the paediatric population but are associated with high mortality1. During these events it is essential that effective interprofessional teamwork and communication exists1.Both physicians and nursing staff must be aware of the symptoms and signs of anaesthetic emergencies and be comfortable2 with their management3. High fidelity simulation is an effective educational tool when used in multiprofessional training sessions in the operating room4.
Description: : In a tertiary care, paediatric surgical department anaesthesiologists are supported by theatre nurses during the delivery of anaesthesia. An educational, simulation course covering rare anaesthetic emergencies was instituted for senior nursing staff, delivered by a consultant paediatric anaesthesiologist who participated in the simulation. This is aimed to improve recognition of anaesthetic emergencies and also make nursing staff aware of local and national management protocols. Peer feedback accompanied self-reflection and assessed clinical knowledge and human factors; such as communication and team working.
The curriculum included:
1. Local anaesthetic toxicity (LAT)
2. Malignant hyperthermia (MH)
3. Management of difficult airway (DA)
4. Anaphylaxis to antibiotics (ANA)
Observation/Evaluation: : A five point Likert scale questionnaire was used to assess participants’ reflections on their confidence in recognising and managing the simulated emergencies (very confident-not confident at all). 10 theatre nurses took part in the course.
Prior to the course nursing staff were confident that they could recognise (5/10) and manage LAT (6/10). 7/10 were confident they could recognise the symptoms of MH and 6/10 were confident they could manage it effectively. 8/10 were confident recognising and managing a difficult airway.
Following the simulations all (10/10) were confident recognising the symptoms and management of the anaesthetic emergencies. The biggest improvement was in nursing staff confidence in the management of MH (Figures 1 & 2)
All participants felt this course was relevant and of benefit in their role. 10/10 strongly agreed that peer feedback was useful when acting as an observer and a candidate.
Discussion: : This simulation course shows that nurses’ confidence in the recognition and management of anaesthetic emergencies can be enhanced by the use of high fidelity simulation. This is especially relevant in rarely occurring crises such as LAT and MH. Nurses prior to the course were confident in the more commonly occurring emergencies and the course was able to improve upon this.
Ongoing professional development through simulation is commonplace for medical staff however this course has shown that it is also beneficial for theatre nurses. Our team is expanding to perform further in-situ simulations of intraoperative anaesthetic emergencies in our department.