Gersten Jonker

86   Chapter 4 options, such as invasive blood pressure, are theoretically available but are not used in the scenarios. The interval between successive blood pressure measurements can be adjusted, alarms can be muted or switched off, and alarm limits changed. Three trolleys are present in the room, containing all the medication commonly used during resuscitation and emergency care, standard airway equipment, and disposables (crystalloid solutions, oxygen face masks, nebulizers, oropharyngeal airways, endotracheal tubes, etc.). A CPR cart is available with a biphasic defibrillator and medication commonly used during CPR (adrenaline, amiodarone). The shockable and non-shockable cardiac arrest algorithms are attached to the CPR cart. An IV pole is present and includes syringe pumps. Oxygen is supplied fromthe hospital medical gases pipeline system. A working suction system is present. A working telephone is mounted on the wall. A desktop computer is available with a working internet connection to facilitate online information searches. Simulation sessions are run by anesthesiologists and anesthetic nurses who are all level 1 EuSim certified simulation facilitators [28]. Participant orientation The simulation session starts with an induction talk describing the program of the day and introduction of all facilitators. Next, participants are offered a tour so they can familiarize themselves with the simulation environment. The tour includes looking at the content of the carts and trolleys and getting acquainted with the look and feel of the manikin and operation of the monitor, piped oxygen and suction system, telephone, and defibrillator. Simulation exposure and scenarios The participant acts individually as the doctor attending to emergency calls to the emergency room or ward. Participants collaborate with a single “nonobstructive” nurse colleague. The nurse is able to provide whatever the student requests (within reason) but does not make any suggestions regarding therapy and drug doses. The nurse can gently prompt the student by asking what the next step or priority will be. The nurse does not correct inappropriate therapy suggestions and will not take the initiative to commence life-saving interventions (e.g. chest compressions). Scenarios have been developed collaboratively by simulation center physicians and physicians involved in student and resident training in anesthesiology, cardiology, emergencymedicine, intensive caremedicine, or respiratorymedicine. Scenarios require acute care for cases of anaphylaxis, postoperative hemorrhage, or acute myocardial