1887
Volume 2017, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

Simulation training is increasingly being used to provide clinical care providers with experience and competence in high-risk procedures that occur infrequently. Implementation of standardized extracorporeal life support (ECLS) simulation training improves multidisciplinary team processes and increases efficiency of establishing ECLS. The initiation of ECLS is a highly complex process that requires technical proficiency of the surgeon and frequently depends on advanced crisis-management skills. Human performance simulation systems can be designed to simulate complex surgical procedures and used to teach and assess technical skills and refine team management protocols. Furthermore, high-fidelity simulators may enhance technical competency and improve patient safety.

The use of ECLS cannulation simulation has been shown to improve proficiency of surgical cannulation.1 However, advanced surgical skills simulators are generally expensive and require extensive setup time.2 The use of commercially available simulation systems that cost >$500 USD per use represents a significant financial burden for many centers that are establishing an ECLS program.

Affordable ( < $10 USD per use), silicone-based ECLS cannulation simulators can be created using commercial available materials. Custom ECLS cannulation simulators may be designed to fulfill specific educational and quality improvement requirements in unique hospital settings. High-fidelity simulation models may be used to accurately recreate anatomic structures. When integrated into a comprehensive ECLS simulation program, cannulation simulators create a more realistic learning environment that more accurately represents clinical scenarios encountered in the clinical management of ECLS patients, including cannula malpositioning events, bleeding, air entrainment, and hypovolemia. In addition, ECLS cannulation simulators can be used to teach and reinforce proper techniques in a standardized manner.

Commercially available, silicone-based materials may be combined to reproduce layers of skin, subcutaneous tissue, blood vessels, and boney. Percutaneous models utilize similar materials but require additional processing to render ECLS cannulation models ultrasound compatible. Cannulation simulators may be integrated with low-cost compliance chambers and tubing to reproduce circulatory physiology after initiating ECLS. Although each cannulation simulator may be used only once, the raw materials for custom-made simulators cost less than $10 USD each. This low cost for production allows centers to use them frequently and incorporate them into existing skills-based ECLS training programs.

Percutaneous cannulation simulators that are designed to reproduce the cervical cannulation with dual-lumen veno-venous ECLS cannulae are being developed by our team. These novel simulators will enable users to perform ultrasound-guided percutaneous reproduce cannulation using standard dual-lumen cannulae and echocardiography. This system will facilitate communication between proceduralists and echocardiographers.

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/content/journals/10.5339/qmj.2017.swacelso.61
2017-02-14
2019-09-16
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References

  1. [1]. Allan   CK., , Pigula   F., , Bacha   EA., , Emani   S., , Fynn-Thompson   F., , Thiagarajan   RR., , Imprescia   A., , Hayes   G., , Weinstock   P. . An extracorporeal membrane oxygenation cannulation curriculum featuring a novel integrated skills trainer leads to improved performance among pediatric cardiac surgery trainees. . Simul Healthc . 2013; ;8: 4 : 221– 228 .
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  2. [2]. Trehan   K., , Kemp   CD., , Yang   SC. . Simulation in cardiothoracic surgical training: Where do we stand?.   J Thorac Cardiovasc Surg . 2014; ;147: 1 : 18– 24 e2 .
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