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Sengstaken-Blakemore Tube Placement: A Simulation-Based Training Program for a High-Acuity, Low-Frequency Procedure
Carolyn Wilson1, Ceena Chandrabos2, Katie Shen3
1Resident, Department of Medicine, New York University Langone Health.
Summary
Simulation training significantly boosted provider confidence in managing Sengstaken-Blakemore tubes (SBTs) for variceal hemorrhage. This hands-on approach is crucial for improving skills in this critical, low-frequency procedure.
Area of Science:
- Medical Education
- Gastroenterology
- Critical Care Medicine
Background:
- Variceal hemorrhage from liver cirrhosis is life-threatening.
- Sengstaken-Blakemore tubes (SBTs) are vital salvage therapy despite declining use.
- Limited provider experience necessitates improved training.
Purpose of the Study:
- To enhance provider familiarity and confidence with Sengstaken-Blakemore tube (SBT) placement and management.
- To address skill gaps in a high-acuity, low-frequency procedure.
Main Methods:
- Implemented a manikin-based simulation program for gastroenterology and critical care fellows and attendings.
- Utilized standardized SBT kits and annual simulation sessions with didactics and hands-on practice.
- Assessed self-reported confidence using pre- and post-session surveys and a Wilcoxon signed-rank test.
Main Results:
- 54 participants completed the 2023 training.
- Prior to training, 20% had formal instruction and 39% had never placed an SBT.
- Confidence significantly increased in SBT placement (3.00-4.30), management (1.78-4.31), and removal (2.17-4.43).
Conclusions:
- Simulation-based training effectively improved self-reported confidence in SBT procedures.
- Structured training is vital for bridging knowledge and skill gaps in critical care procedures.
- Future research should evaluate long-term skill retention and curriculum integration.
