Identifying and Managing Intraoperative Arrhythmia: A Multidisciplinary Operating Room Team Simulation Case.

Area of Science:

• Medical Education
• Cardiology
• Surgical Critical Care

Background:

• Intraoperative cardiac arrest poses significant challenges for healthcare teams, demanding rapid and accurate diagnosis and management.
• Effective resuscitation requires proficiency in Advance Cardiac Life Support (ACLS) algorithms, medications, and defibrillator use.
• A 56-year-old female undergoing lymph node biopsy developed intraoperative cardiopulmonary arrest, presenting three critical scenarios: ventricular fibrillation, unstable ventricular tachycardia, and bradycardia.

Purpose of the Study:

• To implement and evaluate a simulation-based training scenario for managing intraoperative cardiac arrest.
• To assess the effectiveness of the simulation in preparing multidisciplinary teams for critical event management.
• To improve identification and management of various cardiac arrest rhythms during surgery.

Main Methods:

• A multidisciplinary team, including surgical residents, anesthesiology residents, nurses, and surgical technicians, participated in weekly simulation sessions.
• The simulation took place in an in situ operating room at Massachusetts General Hospital, utilizing a high-fidelity patient simulator and standard code equipment.
• Each session involved orientation, the simulated case, and a debriefing, lasting approximately 60 minutes.

Main Results:

• Ninety-one participants completed the simulation scenario between September and December 2015.
• The scenario was highly rated for clinical applicability (96%), teamwork promotion (88%), and interprofessional learning (94%).
• Participants demonstrated engagement and learning in managing complex cardiac arrest situations.

Conclusions:

• Simulation-based training is a valuable tool for preparing healthcare teams to manage devastating intraoperative cardiac arrest events.
• This specific scenario effectively trained multidisciplinary learners in critical event identification and management, enhancing preparedness.
• The simulation fostered teamwork and interprofessional collaboration, crucial for improving patient outcomes during surgical emergencies.