Assignment/exercise
Cardiac Tamponade and Complete Heart Block During Transcatheter Aortic Valve Implantation: A Simulation Scenario for Anesthesia Providers
MedEdPORTAL, Vol.14(1), 10779
Association of American Medical Colleges
11/28/2018
DOI: 10.15766/mep_2374-8265.10779
PMCID: PMC6342360
PMID: 30800979
Abstract
Introduction: This simulation on cardiac tamponade and complete heart block in the context of severe aortic stenosis presents the learner with a rare (cardiac tamponade) and a common (complete heart block) complication in the intraoperative setting of transfemoral aortic valve implantation in a high-fidelity, low-risk simulation environment. Based on an amalgam of index cases, the simulation was developed to address a recognized area of need for cardiothoracic anesthesia scenarios in the simulation curriculum of our home institution. Methods: The simulation case file covered the case narrative, learning objectives, a summary of critical actions performed, and supplemental figures needed to complete the educational activity. A high-fidelity patient simulator, an anesthesia machine, monitors, and a computer capable of displaying standard computer slide presentation software and movie files provided the optimal environment for simulation. Results: Fifteen anesthesia residents experienced the simulation over the 2016–2017 and 2017–2018 academic years. The trainees who experienced this simulation improved their understanding of tamponade hemodynamic pathophysiology and recognition of hemodynamically unstable bradycardia. Discussion: This case has been an effective addition to the repertoire of simulation scenarios at the University of Iowa and has been incorporated into the general curriculum of simulation cases for mid-training junior and senior anesthesia residents.
Educational Objectives
By the end of this simulation, the learner will be able to:
1. Develop and implement a plan for the anesthetic management of patients with aortic stenosis.
2. Demonstrate understanding of hemodynamic monitoring with a pulmonary arterial catheter.
3. Diagnose and manage acute cardiac tamponade in the surgical setting.
4. Discuss the common complications associated with transcatheter aortic valve implantation and their management.
5. Diagnose and demonstrate the treatment of hemodynamically unstable bradycardia in the context of complete heart block.
6. Discuss areas of strength and areas for improvement discovered during the simulation.
Details
- Title: Subtitle
- Cardiac Tamponade and Complete Heart Block During Transcatheter Aortic Valve Implantation: A Simulation Scenario for Anesthesia Providers
- Creators
- Robert Hitchcock - Clinical Associate Anesthesiologist, Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of MedicineClark J Obr - Clinical Associate Professor, Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of MedicineSudhakar Subramani - Clinical Assistant Professor, Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Assignment/exercise
- Publication Details
- MedEdPORTAL, Vol.14(1), 10779
- DOI
- 10.15766/mep_2374-8265.10779
- PMID
- 30800979
- PMCID
- PMC6342360
- NLM abbreviation
- MedEdPORTAL
- ISSN
- 2374-8265
- eISSN
- 2374-8265
- Publisher
- Association of American Medical Colleges
- Language
- English
- Date published
- 11/28/2018
- Academic Unit
- Anesthesia
- Record Identifier
- 9984006489302771
Metrics
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