Simulation in healthcare : journal of the Society for Simulation in Healthcare
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Randomized Controlled Trial
Improving patient safety with ultrasonography guidance during internal jugular central venous catheter placement by novice practitioners.
This study compared ultrasonography-guided (USG) placement with anatomic placement during internal jugular (IJ) central venous catheter (CVC) insertion by novice practitioners using a simulation model. ⋯ The USG during IJ CVC placement by novice practitioners is essential to improve patient safety. If these data are extrapolated to impact on patient care, an arterial stick may be avoided in one of every two IJ CVCs placed by novice practitioners. The USG technology should be made available to novice practitioners needing to place CVCs.
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Comparative Study
Comparison of intubation success of video laryngoscopy versus direct laryngoscopy in the difficult airway using high-fidelity simulation.
A number of devices, including video laryngoscopy, are used to aid in managing difficult airways. The goal of this study was to compare timing and success of video laryngoscopy to standard laryngoscopic intubation using a simulation mannequin in normal and difficult airway scenarios. ⋯ In the most difficult airway case, tongue edema, the video laryngoscope provided an enhanced view of the cords using less time, increased intubation success, and decreased the time to intubation.
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Given the emphasis on early vascular access via the umbilical vein in neonatal resuscitation it is essential that participants in neonatal resuscitation simulation training be given the opportunity to practice both the placement and use of an emergency umbilical venous catheter. By integrating available parts from the Laerdal catalog, combined with a few other inexpensive components, into a Laerdal SimBaby we were able to create a single, integrated neonatal simulator that could be used to practice both the placement and use of an emergent umbilical vein catheter. ⋯ We have developed a modification to the Laerdal SimBaby involving the integration of a usable umbilical cannulation task trainer. The modification was easily accomplished using available parts from the Laerdal catalog and a few other inexpensive components. Given the emphasis on early vascular access via the umbilical vein and the complexities involved with the administration of medications and fluids via this route we believe that a usable umbilical cannulation task trainer is essential to neonatal resuscitation simulation training. When modified as described the Laerdal SimBaby can act as a high-fidelity newborn simulator that allows participants to practice both the placement and use of an emergency umbilical vessel catheter. Given our positive experience we think others could apply the above modification to their own SimBaby.