In-Flight Emergency: A Simulation Case for Emergency Medicine Residents

Abstract

Introduction: In-flight medical emergencies are common occurrences that require medical professionals to manage patients in an unfamiliar setting with limited resources. Emergency medicine (EM) residents should be well prepared to care for patients in unusual environments such as on an aircraft. Methods: We developed a simulation case for EM residents featuring a 55-year-old male passenger who suffers a cardiac arrest secondary to a tension pneumothorax. We conducted this case eight times during a 5-hour block of scheduled simulation time. Participants included EM residents of all training levels from one residency program. We arranged the simulation lab as an airplane cabin, with rows of chairs representing airplane seats and a mannequin in a window seat as the patient. Residents were expected to manage cardiac arrest and perform needle thoracostomy on the patient. Residents also evaluated and treated a flight attendant with a near syncopal episode. Throughout the case, residents were expected to practice teamwork skills, including leadership, communication, situational awareness, and resource utilization. Participants were debriefed and completed voluntary anonymous evaluations of the session. Results: Seventeen EM residents participated in the simulation. Overall, all 17 found the simulation to be a valuable educational experience. In addition, all agreed or strongly agreed that they felt more prepared to respond to an in-flight emergency after participating in the simulation. Discussion: This simulation was determined to be a valuable part of EM resident education. The challenges presented and skills practiced in this in-flight medical emergency simulation case are transferable to other resource-limited environments.

Perception, confidence, and willingness to respond to in-flight medical emergencies among medical students: a cross sectional study

“…Relatively more IME training programs for emergency medicine residents have been described in the literature, which can be adapted to the needs and demands of senior medical students within the SaudiMED framework and the National Commission for Academic Accreditation and Assessment (NCAAA) that evaluates the quality of post-secondary programs [ 16 ]. For example, a hands-on simulation training program for emergency medicine residents at Vanderbilt University Medical Center focused on identifying roles and resources and patient evaluation and management during an IME [ 26 ]. The participants rated the program highly for improving their preparedness [ 26 ].…”

“…For example, a hands-on simulation training program for emergency medicine residents at Vanderbilt University Medical Center focused on identifying roles and resources and patient evaluation and management during an IME [ 26 ]. The participants rated the program highly for improving their preparedness [ 26 ]. Another program at Ohio State University Wexner Medical Center conducted a realistic simulation training using a grounded Boeing 737 airliner at the local airport, which included five simulation-based learning (anaphylaxis, shockable rhythm arrest, syncope secondary to pulmonary embolism, anterior epistaxis, and an agitated passenger) and three discussion-based learning (aeromedical considerations, medicolegal topics, and decompression illness) for emergency and internal medicine residents [ 27 ].…”

A First-Class Simulation: In-Situ In-Flight Medical Emergencies Curriculum for Emergency Medicine Residents Aboard a Commercial Airliner

“…Previously published in-flight medical emergency simulation scenarios were held in a dedicated simulation center or educational facilities [7][8][9][10][11]. One utilized a critical actions checklist for performance assessment but did not report these results [7].…”

“…Previously published in-flight medical emergency simulation scenarios were held in a dedicated simulation center or educational facilities [7][8][9][10][11]. One utilized a critical actions checklist for performance assessment but did not report these results [7]. A hypoglycemia in-flight emergency simulation case did not report any objective or competency-based results from their training [8].…”

“…Previous publications of in-flight medical emergencies described individual simulation scenarios [ 7 , 8 ], a curriculum for medical students consisting of a lecture and a simulation scenario [ 9 ], a simulation-based curriculum for medical students participating in a wilderness and extreme environmental medicine elective [ 10 ], and use of a mobile phone application for assistance with management of in-flight medical emergency scenarios [ 11 ]. These educational interventions were held in standard simulation settings.…”