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Updated: Jun 25, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Using simulation to prepare multidisciplinary teams and clinical environments for complex fetal interventions and
Louis P Halamek1,2, Yair J Blumenfeld3, Karthik Balikrishnan4
1Division of Neonatology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, USA. halamek@stanford.edu.
Objective:
Identify overt and latent weaknesses in preliminary plans for initiating a Fetoscopic Endoluminal Tracheal Occlusion program.
Study Design:
Clinical scenarios involving placement and removal of a fetal tracheal occlusion device for fetuses with severe congenital diaphragmatic hernia were simulated. All sessions took place in the actual hospital environments and were captured on video for later playback, transcription and analysis.
Results:
Simulation-based investigation produced: • a list of plausible scenarios • lists of equipment required • diagrams of room setup and positioning of personnel • decision trees for each scenario • situation awareness issues • workflow issues • areas requiring additional planning.
Conclusions:
Using appropriate patient simulators and task trainers, teams experienced multiple realistic scenarios that facilitated the development of equipment lists, room setup diagrams, and tactics to remediate identified weaknesses. Simulation is a useful strategy to prepare for the implementation of new, high-risk clinical programs.
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