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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
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:
- 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.