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Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers
INTRODUCTION: Cardiac arrest in pregnancy is rare. Advanced Cardiovascular Life Support courses rarely address interventions specific to obstetric patients, and knowledge gaps are frequent among providers. The Society for Obstetric Anesthesia and Perinatology and American Heart Association have publ...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Association of American Medical Colleges
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342402/ https://www.ncbi.nlm.nih.gov/pubmed/30800968 http://dx.doi.org/10.15766/mep_2374-8265.10768 |
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author | Lee, Allison Sheen, Jean-Ju Richards, Stacey |
author_facet | Lee, Allison Sheen, Jean-Ju Richards, Stacey |
author_sort | Lee, Allison |
collection | PubMed |
description | INTRODUCTION: Cardiac arrest in pregnancy is rare. Advanced Cardiovascular Life Support courses rarely address interventions specific to obstetric patients, and knowledge gaps are frequent among providers. The Society for Obstetric Anesthesia and Perinatology and American Heart Association have published guidelines regarding management of cardiac arrest in pregnancy, and interdisciplinary simulation training has been advocated to reinforce key management points for this clinical scenario. METHODS: In situ multidisciplinary simulation training was implemented for anesthesia and maternal fetal medicine fellows and obstetric nurses at our hospital. The case was amniotic fluid embolism in a 35-year-old parturient at term. The patient had a witnessed seizure before cardiovascular collapse. Learners were expected to initiate high-quality cardiopulmonary resuscitation and perform a perimortem cesarean delivery within 5 minutes while demonstrating clear communication with each other. The case required a labor room, high-fidelity mannequin, defibrillator, code cart, cesarean section instruments, and simulated medications and intravenous fluids. RESULTS: Participants comprised two obstetric anesthesia fellows, three maternal fetal medicine fellows, and three obstetric nurses. Positive feedback about the training and increased perceptions of self-efficacy were received. Potential systems issues were detected and corrected because of the training, highlighting the value of in situ drills. DISCUSSION: We found it challenging to implement more frequent multidisciplinary sessions, but participants found the experience highly rewarding. We hope to expand the training to all physicians and nurses covering the unit on a regular basis. Modified scenario versions are being used for nursing-only and obstetric resident-only simulations during protected teaching time for those services. |
format | Online Article Text |
id | pubmed-6342402 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Association of American Medical Colleges |
record_format | MEDLINE/PubMed |
spelling | pubmed-63424022019-02-22 Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers Lee, Allison Sheen, Jean-Ju Richards, Stacey MedEdPORTAL Original Publication INTRODUCTION: Cardiac arrest in pregnancy is rare. Advanced Cardiovascular Life Support courses rarely address interventions specific to obstetric patients, and knowledge gaps are frequent among providers. The Society for Obstetric Anesthesia and Perinatology and American Heart Association have published guidelines regarding management of cardiac arrest in pregnancy, and interdisciplinary simulation training has been advocated to reinforce key management points for this clinical scenario. METHODS: In situ multidisciplinary simulation training was implemented for anesthesia and maternal fetal medicine fellows and obstetric nurses at our hospital. The case was amniotic fluid embolism in a 35-year-old parturient at term. The patient had a witnessed seizure before cardiovascular collapse. Learners were expected to initiate high-quality cardiopulmonary resuscitation and perform a perimortem cesarean delivery within 5 minutes while demonstrating clear communication with each other. The case required a labor room, high-fidelity mannequin, defibrillator, code cart, cesarean section instruments, and simulated medications and intravenous fluids. RESULTS: Participants comprised two obstetric anesthesia fellows, three maternal fetal medicine fellows, and three obstetric nurses. Positive feedback about the training and increased perceptions of self-efficacy were received. Potential systems issues were detected and corrected because of the training, highlighting the value of in situ drills. DISCUSSION: We found it challenging to implement more frequent multidisciplinary sessions, but participants found the experience highly rewarding. We hope to expand the training to all physicians and nurses covering the unit on a regular basis. Modified scenario versions are being used for nursing-only and obstetric resident-only simulations during protected teaching time for those services. Association of American Medical Colleges 2018-10-26 /pmc/articles/PMC6342402/ /pubmed/30800968 http://dx.doi.org/10.15766/mep_2374-8265.10768 Text en Copyright © 2018 Lee et al. https://creativecommons.org/licenses/by-nc-sa/4.0/legalcode This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike (https://creativecommons.org/licenses/by-nc-sa/4.0/legalcode) license. |
spellingShingle | Original Publication Lee, Allison Sheen, Jean-Ju Richards, Stacey Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title | Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title_full | Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title_fullStr | Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title_full_unstemmed | Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title_short | Intrapartum Maternal Cardiac Arrest: A Simulation Case for Multidisciplinary Providers |
title_sort | intrapartum maternal cardiac arrest: a simulation case for multidisciplinary providers |
topic | Original Publication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342402/ https://www.ncbi.nlm.nih.gov/pubmed/30800968 http://dx.doi.org/10.15766/mep_2374-8265.10768 |
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