Assignment/exercise
Apnea in Beach-Chair Position Status Post Interscalene Block: A Simulation Case for Anesthesia Residents
MedEdPORTAL, Vol.12(1), 10489
10/31/2016
DOI: 10.15766/mep_2374-8265.10489
PMCID: PMC6440401
PMID: 30984831
Abstract
Regional anesthesia is commonly performed for orthopedic operations, especially in situations when general anesthesia is preferably avoided. Anesthesia residents should understand the complications of regional procedures and should know how to treat them if treatment is warranted. This simulation involves a 60-year-old man who became apneic in the beach-chair position following an interscalene block for rotator cuff repair. It presents trainees with the opportunity to further their learning with regard to perioperative management and associated complications of patients receiving brachial plexus blocks.
This simulation is designed to be delivered in a single, 1-hour session. Materials contained within this simulation include a case template, a checklist of critical actions, a brief summary for key takeaways, and an evaluation form. At the conclusion of this simulation and debriefing session, the learner has had the opportunity to demonstrate progress in several of the anesthesiology milestones outlined by the Accreditation Council for Graduate Medical Education and the American Board of Anesthesiology in the Anesthesiology Milestone Project as they relate to this particular clinical topic.
At the time of this submission, a total of 15 junior residents had completed this simulation. Commonly missed critical actions included difficulty of management of analgesia in a block that is not complete and correlation between noninvasive blood pressure on the arm and cerebral perfusion pressure. Learners' comments were generally positive, indicating the residents felt this simulation was a worthwhile learning experience.
The majority of anesthesia residents who have participated in this simulation were able to properly address apnea in the beach-chair position following a brachial plexus block. It is expected that this simulation will be performed approximately 15-20 times annually.
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Educational Objectives
By the end of this simulation, the learner will be able to:
1. Discuss relevant risk factors of performing an interscalene block in patients with chronic obstructive pulmonary disease (Anesthesia Milestones [AM]: Patient Care [PC] 1, PC 3, PC 7, PC 10).
2. Formulate an anesthetic plan (general anesthesia vs. monitored anesthesia care; AM: PC 1, PC 2, PC 3).
3. Maintain cerebral perfusion pressure in the beach-chair position (AM: PC 4, PC 5, PC 9).
4. Manage an airway in the beach-chair position (AM: PC 4, PC 5, PC 8).
Details
- Title: Subtitle
- Apnea in Beach-Chair Position Status Post Interscalene Block: A Simulation Case for Anesthesia Residents
- Creators
- Tyler Voigt - Senior Resident, Department of Anesthesiology, University of Iowa Roy J. and Lucille A. Carver College of MedicineAllison Wagner - Senior Resident, Department of Anesthesiology, University of Iowa Roy J. and Lucille A. Carver College of MedicineClark Obr - Clinical Associate Professor, Department of Anesthesiology, University of Iowa Roy J. and Lucille A. Carver College of MedicineTejinder Swaran Singh - Clinical Assistant Professor, Department of Anesthesiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Assignment/exercise
- Publication Details
- MedEdPORTAL, Vol.12(1), 10489
- DOI
- 10.15766/mep_2374-8265.10489
- PMID
- 30984831
- PMCID
- PMC6440401
- NLM abbreviation
- MedEdPORTAL
- ISSN
- 2374-8265
- eISSN
- 2374-8265
- Publisher
- United States
- Language
- English
- Date published
- 10/31/2016
- Academic Unit
- Anesthesia
- Record Identifier
- 9984006486602771
Metrics
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