Computers in radiology. The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents.
BACKGROUND
Awareness and preparedness to handle sedation, analgesia, and contrast-media complications are key in the daily radiology practice.


OBJECTIVE
The purpose is to create a computerized simulator (PC-Windows-based) that uses a graphical interface to reproduce critical incidents in pediatric and adult patients undergoing a wide spectrum of radiologic sedation, analgesia and contrast media complications.


METHODS
The computerized simulator has a comprehensive set of physiologic and pharmacologic models that predict patient response to management of sedation, analgesia, and contrast-media complications. Photorealistic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis.


RESULTS
Thirteen pediatric and adult radiology scenarios are illustrated encompassing areas such as pediatric radiology, neuroradiology, interventional radiology, and body imaging. The multiple case scenarios evaluate randomly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstruction, apnea, agitation, bronchospasm, hypotension, hypertension, cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control the airway, breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the program to suggest diagnostic and treatment steps to save the patient, and provide information about the medications. A printout of the case management can be obtained for evaluation or educational purposes.


CONCLUSIONS
The interactive computerized simulator is a new approach to train and evaluate radiologists' responses to critical incidents encountered during radiologic sedation, analgesia, and contrast-media administration.
Medina
L S
LS
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Racadio
J M
JM
Schwid
H A
HA
D000328:Adult; D000698:Analgesia / Q000009:adverse effects; D000707:Anaphylaxis / Q000139:chemically induced / Q000628:therapy; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000628:therapy; D002648:Child; D003198:Computer Simulation; D016292:Procedural Sedation / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D062787:Drug Overdose / Q000628:therapy; D005069:Evaluation Studies as Topic; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D015642:Radiology, Interventional / Q000193:education* / Q000379:methods
D003287:Contrast Media