飞行中的医疗紧急情况是常见的事件,需要医疗专业人员以有限的资源在不熟悉的环境中管理患者。急诊医学(EM)居民应做好充分的准备,以照顾飞机等不寻常环境中的患者。
我们为EM居民开发了一个模拟案例,其中包括一名55岁的男性乘客,他因张力性气胸而遭受心脏骤停。我们在5小时的预定模拟时间内进行了八次这种情况。参与者包括来自一个居住计划的所有培训级别的EM居民。我们把模拟实验室安排成飞机舱,一排排代表飞机座位的椅子和一个坐在靠窗座位上的人体模型作为病人。预计居民将处理心脏骤停并对患者进行针式胸廓造口术。居民还评估并治疗了一名近乎晕厥的空乘人员。在整个案件中,居民应该练习团队合作技能,包括领导力,通信,态势感知,和资源利用。与会者听取了汇报,并完成了对会议的自愿匿名评估。
17名EM居民参与了模拟。总的来说,所有17人都发现模拟是宝贵的教育经验。此外,所有人都同意或强烈同意,他们在参与模拟后感到更有准备应对飞行中的紧急情况。
该模拟被确定为EM住院医师教育的重要组成部分。在此飞行中的医疗紧急情况模拟案例中提出的挑战和实践的技能可转移到其他资源有限的环境中。
In-flight medical emergencies are common occurrences that require medical professionals to manage patients in an unfamiliar setting with limited resources. Emergency medicine (EM) residents should be well prepared to care for patients in unusual environments such as on an aircraft.
We developed a simulation
case for EM residents featuring a 55-year-old male passenger who suffers a cardiac arrest secondary to a tension pneumothorax. We conducted this
case eight times during a 5-hour block of scheduled simulation time. Participants included EM residents of all training levels from one residency program. We arranged the simulation lab as an airplane cabin, with rows of chairs representing airplane seats and a mannequin in a window seat as the patient. Residents were expected to manage cardiac arrest and perform needle thoracostomy on the patient. Residents also evaluated and treated a flight attendant with a near syncopal episode. Throughout the
case, residents were expected to practice teamwork skills, including leadership, communication, situational awareness, and resource utilization. Participants were debriefed and completed voluntary anonymous evaluations of the session.
Seventeen EM residents participated in the simulation. Overall, all 17 found the simulation to be a valuable educational experience. In addition, all agreed or strongly agreed that they felt more prepared to respond to an in-flight emergency after participating in the simulation.
This simulation was determined to be a valuable part of EM resident education. The challenges presented and skills practiced in this in-flight medical emergency simulation
case are transferable to other resource-limited environments.