title: Simulation as a tool to improve the safety of pre-hospital anaesthesia--a pilot study.
abstract: We conducted a pilot study of the effects of simulation as a tool for teaching doctor-paramedic teams to deliver pre-hospital anaesthesia safely. Participants undertook a course including 43 full immersion, high-fidelity simulations. Twenty videos taken from day 4 and days 9/10 of the course were reviewed by a panel of experienced pre-hospital practitioners. Participants' performance at the beginning and the end of the course was compared. The total time from arrival to inflation of the tracheal tube cuff was longer on days 9/10 than on day 4 (mean (SD) 14 min 52 s (2 min 6 s) vs 11 min 28 s (1 min 54 s), respectively; p = 0.005), while the number of safety critical events per simulation were fewer (median (IQR [range]) 1.0 (0-1.8 [0-2]) vs 3.5 (1.5-4.8 [0-8], respectively; p = 0.011). Crew resource management behaviours also improved in later simulations. On a personal training needs analysis, participants reported increased confidence after the course.
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Batchelder
authors.forename: A
authors.initials: A
authors.lastname: Steel
authors.forename: R
authors.initials: R
authors.lastname: Mackenzie
authors.forename: A P
authors.initials: AP
authors.lastname: Hormis
authors.forename: T S
authors.initials: TS
authors.lastname: Daniels
authors.forename: N
authors.initials: N
authors.lastname: Holding
mesh_terms: D000758:Anesthesia / Q000592:standards; D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education; D006801:Humans; D007442:Intubation, Intratracheal / Q000592:standards; D010348:Patient Care Team / Q000592:standards; D016544:Patient Simulation; D010865:Pilot Projects; D012449:Safety; D013997:Time Factors