1. Create a realistic environment
A few years back, I was at a medical conference where a healthcare
professional with past military experience stressed how simulation
training is important in maintaining safe patient care. In the military,
they drill again and again until responses become second nature. I
wanted our MH simulation to mirror that approach.
Our SBT is done in an OR on a morning before cases start. I have
access to CPR mannequins and went to work creating a training envi-
ronment that was as accurate and realistic as possible. That meant
intubating the mannequin with an anesthesia circuit, placing an IV line
and draping it for surgery.
We also placed a warming blanket on the "patient" and set up the
back table and mayo stand. Finally, we gathered all the supplies we'd
likely use in the event of an MH crisis, including expired dantrolene
and sterile water, syringes, mini-dispensing pins, an extra anesthesia
cart, Foley catheter, vascular access supplies and empty syringes that
we mark up for emergency medications during the simulation. All the
supplies were placed outside of the OR where we conducted the drill.
2. Simulate everything
When staff — nurses, surgical techs and, of course, an anesthesia
provider to lead the drill — enter the OR for the training, the first
thing they're asked to do is answer a seven-question pre-simulation
questionnaire that tests their knowledge of proper response proto-
cols.
After completing the questionnaire, staff are instructed to gather
the practice items — everything from the MH cart to bags of ice —
they'd use during an MH event.
We require staff to do everything exactly as they would in the event
of a real emergency. That means making sure they physically leave the
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