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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

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Development of a bleeding arteriovenous fistula task trainer.

Emily K Pauw¹, Ryan Walsh¹

¹Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

The Journal of Emergency Medicine

|September 5, 2024

Summary

Emergency medicine residents trained with a new AV fistula hemorrhage simulator reported increased confidence in managing this rare, life-threatening complication. The inexpensive, easily made task trainer effectively prepared trainees for critical bleeding scenarios.

Keywords:

Arteriovenous fistula End-stage renal disease Hemorrhage Procedures Residency education

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Area of Science:

Medical Education
Emergency Medicine
Surgical Simulation

Background:

Increasing prevalence of end-stage renal disease leads to more arteriovenous (AV) fistulas.
Life-threatening hemorrhage is a feared complication of AV fistulas, posing an immediate risk to patients.
Emergency medicine providers require effective training for managing AV fistula hemorrhage.

Purpose of the Study:

To develop and evaluate a task trainer model for simulating AV fistula hemorrhage.
To prepare emergency medicine residents for rapid and effective treatment of this complication.

Main Methods:

A low-cost, easily constructed task trainer model was developed.
Twenty-one emergency medicine residents participated in a training session including a didactic and hands-on simulation.
Post-training surveys assessed resident feedback and confidence levels.

Main Results:

The task trainer and overall teaching session received high ratings from residents.
Statistically significant improvements in confidence were reported post-training.
The model is inexpensive and made from readily available materials.

Conclusions:

This is the first published task trainer for simulating AV fistula hemorrhage for emergency medicine residents.
The model was well-received and is suitable for trainees across disciplines.
The task trainer effectively prepares clinicians for a potentially catastrophic patient presentation.