Anesthesia crisis resource management: Real-life simulation training in operating room crises
Anesthesia crisis resource management: Real-life simulation training in operating room crises
复制标题
DOI：
10.1016/0952-8180(95)00146-8
复制
发表时间：
1995-12-01
影响因子：
6.7
通讯作者：
Feinstein, D
中科院分区：
文献类型：
--
作者：
Holzman, RS;Cooper, JB;Feinstein, D
在麻醉住院医师项目中，很少有正式的培训可以帮助获得、发展和实践危机期间的资源管理和决策技能。使用麻醉危机资源管理（ACRM）的原则，在另一个机构，68名麻醉师和4名护士麻醉师参加了ACRM培训课程举行了2个半月的时间。在真实的手术室中重建麻醉环境，使用标准设备和需要实际执行临床干预的模拟。场景包括吸入麻醉剂过量、氧气源故障、心脏骤停、恶性高热、张力性气胸和完全断电。在听取情况汇报后，向所有与会者发放了一份详细的问卷，并由他们填写，记录了他们的直接印象。参与者认为自己在模拟器中表现良好。高级主治医师和住院医师对自己的评价比初级主治医师和住院医师更高。这门课程对于麻醉医师在受控运动环境中更安全地进行麻醉的潜在益处，两组都给予了高度评价。所有类别中超过一半的受访者认为应该每12个月参加一次课程;每组中另外三分之一的人认为应该每24个月参加一次课程。虽然没有高级主治医生认为该课程应每6个月参加一次，但其他类别中约有10%的受访者认为应该这样做。在高级和初级参加类别的受访者中，5%的人认为永远不应该参加这门课程。虽然主治医生对课程价值的评价不如住院医生好，但两组人仍然很热情。
Little formal training is provided in anesthesiology residency programs to help acquire, develop, and practice skills in resource management and decision making during crises in practice. Using anesthesia crisis resource management (ACRM) principles developed at another institution, 68 anesthesiologists and 4 nurse-anesthetists participated in an ACRM training course held over a 2 and a half-month period. The anesthesia environment was recreated in a real operating room, with standard equipment and simulations requiring actual performance of clinical interventions. Scenarios included overdose of inhalation anesthetic, oxygen source failure, cardiac arrest, malignant hyperthermia, tension pneumothorax, and complete power failure. A detailed questionnaire was administered following the debriefing and completed by all participants, documenting their immediate impressions. Participants rated themselves as having performed well in the simulator. Senior attendings and residents rated themselves more highly than did their junior counterparts. The potential benefit of this course for anesthesiologists to practice anesthesia more safely in a controlled exercise environment, was rated highly by both groups.Over one half of respondents in all categories felt that the course should be taken once every 12 months; another third of each group felt that the course should be taken once every 24 months. While no senior attendings believed that the course should be taken once every 6 months, approximately 10% of respondents in other categories that it should. Of respondents in the senior and junior attending category, 5% felt the course should never be taken. Although attendings were less favorable than residents in their rating of the value of the course, both groups were still enthusiastic.