Intraoperative Simulation: Team Training for Resuscitation While Using Intraoperative Computed Tomography:...

Area of Science:

• Neurosurgery
• Medical Simulation
• Patient Safety

Background:

• Intraoperative computed tomography (iCT) offers benefits like reduced radiation and improved accuracy in spine surgery.
• The large iCT equipment footprint can hinder emergency resuscitation access, especially with prone patients and head fixation.
• Effective emergency resuscitation requires overcoming significant logistical challenges with a coordinated team.

Purpose of the Study:

• To develop and evaluate a protocol for optimizing emergency resuscitation during spine surgery utilizing iCT.
• To enhance team cohesion and preparedness for intraoperative emergencies in the iCT environment.

Main Methods:

• Conducted simulation sessions to identify and address challenges in iCT-equipped operating rooms.
• Modified operating room setup with extended tubing, portable monitors, and additional IV access.
• Developed educational diagrams for bed positioning and equipment removal to facilitate emergency access.

Main Results:

• A protocol was implemented, leading to successful resuscitation of a patient with intraoperative cardiac arrest within 5 minutes.
• The patient experienced no neurological deficits post-resuscitation and was discharged.
• Stakeholders credited the simulated practice with the positive clinical outcome.

Conclusions:

• Regular simulation and protocol refinement are crucial for maintaining emergency readiness in iCT suites.
• The implemented protocol effectively addressed challenges, ensuring timely and high-quality emergency care.
• Preparedness through simulation significantly contributes to positive patient outcomes during critical intraoperative events.