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Catheter Lab Emergencies Management Simulation (CLEMS)

Session Moderated Poster 1: Interventional cardiology

Speaker

Congress : Acute Cardiovascular Care 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Cardiac Care - Resuscitation
  • Session type : Moderated Posters
  • FP Number : 36

Authors : T I Strang (Manchester,GB), J Sarma (Manchester,GB), L Wee (Manchester,GB), S Cummins (Manchester,GB), E Murtagh (Manchester,GB), L Szentgyorgyi (Manchester,GB)

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Authors:
T I Strang1 , J Sarma1 , L Wee1 , S Cummins1 , E Murtagh1 , L Szentgyorgyi1 , 1University Hospital of South Manchester NHS Foundation Trust, North West Heart Centre - Manchester - United Kingdom ,

Citation:

Introduction: Work within cardiac catheter lab is rapidly advancing with increasingly complex procedures on patients with multiple co-morbidities. This results in a steep learning curve for team members and an increased need for vigilance, situation awareness and effective teamwork. The rapid development of simulation technology provides a safe and realistic environment in which to develop important non-technical skills as part of a multidisciplinary team.

Methods:  A multidisciplinary team of catheter laboratory staff from the Manchester University NHS Foundation Trust developed a two-day simulation course using a multimodal format including lectures, high fidelity simulations and small group workshops. The course focuses on 4 major learning points:
 1. An enhanced WHO (Safe Surgery) [1] style checklist approach with an enhanced ‘team huddle’  with effective use of pre-procedure checklists and notably resuscitative team role allocation.
 2. Acceptance that the procedural cardiologist has too many technical tasks to function as a resuscitative team leader.
 3. Candidates develop a structured approach to the recognition, assessment and management of the critical ill patient, develop their non-technical human factors skills through experiential learning simulating clinical scenarios. Six high fidelity simulations are based in the laboratory and recovery room followed by debriefing. Scenarios include ventricular fibrillation, anaphylaxis, tamponade and major haemorrhage. All are followed by detailed structured de-brief.
 4. Workshops and lectures are designed to teach and develop practical skills and knowledge used in the initial management of a deteriorating or critical ill patient including basic airway skills, post resuscitation care and safe sedation.

Results: Feedback has revealed that 100% of candidates agreed or strongly agreed that the varied learning formats were easy to understand, relevant and useful for future clinical practice. 100% of candidates believed that the knowledge and skills gained would be useful to their future clinical practice, that it helped consolidate their learning and that the facilitation of their debriefing was effective.

Discussion: This multidisciplinary course has been designed to develop an effective team approach to critical situations in the cardiac catheter laboratory. Course development includes investigating the link between attendance on the course and change in practice and improved patient care.



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