vidual staff members don't feel singled out, draw names to determine
who will participate in the simulation. When a staff member's name is
drawn, they get to draw the next name. Drawing names gives team
members a sense of control. Once they get over the initial stage fright
and the simulation begins, they'll assume their roles and get to work.
We drew four names out of a bucket to act the roles of RN Circulator
#1, RN Circulator #2, surgical technician and runner. The remaining
staff observed. Have the four staff members whose names were drawn
stand outside the OR and inform them of the simulated situation. In our
case, we told the staff a patient was undergoing a laparoscopic appen-
dectomy and informed them of the patient's health history and baseline
vital signs. When the staff members entered the OR, they found a
patient with a simulated IV on the operating table and staff acting as the
anesthesia provider, surgeon and resident.
A few minutes into the procedure, the anesthesia provider
announced the patient was showing the early warning signs of MH.
The circulators recognized the problem and jumped into action.
3. Add to the realism
M ake a simulation as realistic as possible to ensure the OR staff treats
the exercise as if it were the real thing, making it an effective learning
experience. We had a staffer from another department act as the
patient. He laid on the OR table, wore a patient gown, held an ET tube
in his mouth that was connected to the anesthesia circuit, had a Bair
Hugger blanket on and a back table was set up as it would normally
be for surgery. We also set up an IV that ran a drainage pack that hid
under the patient to simulate administering medications. We even
worked with our hospital's pharmacy department to fill empty med-
ication vials with simulated dantrolene powder, which we made by
adding orange Crystal Light to water. It was important for OR staff to
3 2 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 2 0
