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Management of anaphylactic shock evaluated using a full-scale anaesthesia simulator.

J Jacobsen¹, A L Lindekaer, H T Ostergaard

¹Department of Anaesthesiology, Herlev Hospital, University of Copenhagen, Denmark.

Acta Anaesthesiologica Scandinavica

|February 24, 2001

Summary

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Anaphylactic shock during anesthesia is difficult to diagnose and manage. This study found that even with training, anesthesiologists struggled with timely diagnosis and structured treatment protocols in a simulated environment.

Area of Science:

Anesthesiology
Critical Care Medicine
Medical Simulation

Background:

Anaphylactic reactions during anesthesia are often overlooked by anesthesiologists.
Early diagnosis and prompt management are crucial for patient outcomes.

Purpose of the Study:

To evaluate anesthesiologists' diagnostic and treatment strategies for anaphylaxis during anesthesia.
To assess the application of anesthesia crisis resource management (ACRM) in simulated anaphylactic events.

Main Methods:

Forty-two anesthesiologists participated in a simulated anaphylactic shock scenario in a full-scale simulator.
Teams of two were evaluated on medical treatment adherence and ACRM performance by trained observers.

Main Results:

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No team correctly diagnosed anaphylaxis within the first 10 minutes.
Only 6/21 teams identified the correct diagnosis after instructor prompts at 15 minutes.
The overall ACRM performance received a median score of 2.0 (range 1-3), indicating suboptimal application.

Conclusions:

Anaphylactic shock presents diagnostic challenges for anesthesiologists in simulated settings.
Structured treatment plans were not consistently applied during the simulated anaphylaxis incident.