Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation

Area of Science:

• Critical care medicine
• Emergency medicine
• Transport medicine

Background:

• Cardiogenic shock presents a high morbidity and mortality burden, often necessitating interfacility transfer.
• Acute myocardial infarction is the primary cause, leading to refractory hypotension and end-organ dysfunction requiring advanced support.
• Effective management prior to transport is crucial for patient outcomes.

Purpose of the Study:

• To educate critical care transport providers on best practices for managing cardiogenic shock patients.
• To enhance skills in resuscitation, intubation, and ventilatory support for unstable patients requiring transport.
• To improve interdisciplinary team preparedness in handling critical cardiogenic shock cases.

Main Methods:

• High-fidelity simulation sessions were conducted for interdisciplinary teams, including physicians and nurses.
• Learners managed a simulated patient with cardiogenic shock and respiratory distress.
• Sessions included debriefing, discussion, and participant feedback for iterative simulation refinement.

Main Results:

• All 36 participants (physicians and nurses) reported the simulation met their educational needs.
• 100% of surveyed participants strongly agreed the simulation was effective and would change future practice.
• Simulation adjustments based on feedback enhanced focus on non-invasive ventilation and post-intubation care.

Conclusions:

• The high-fidelity simulation effectively educated learners on cardiogenic shock resuscitation.
• The program demonstrated success in improving management of vasopressors and ventilatory support.
• This simulation is a valuable tool for critical care transport providers and can be adapted for inpatient settings.