Simulation und Atemwegsmanagement

Abstract

Despite the development of new devices and strategies to manage and secure the difficult airway, morbidity and mortality in anaesthesia due to airway problems such as difficult intubation or unrecognised failed intubation remain high. The problem seems to lie in the transfer of skills and strategies to daily clinical practice. Common methods for airway management training include theoretical instructions and hands-on sessions with manikins, animal models and cadavers. Simulation provides the opportunity to train skills and resolve specific situations embedded in a realistic scenario, facilitate the transfer of cognitive, psychomotor and affective abilities into daily clinical practice and help to improve behaviour in critical situations. This article outlines new training concepts in airway management with the help of simulation and simulators. We describe technical prerequisites and provide information on the implementation of difficult airway scenarios.

Role of advanced simulation in undergraduate and postgraduate medical education

“…[50] Simulation techniques can provide the skills training to solve specific problems in a virtual scenario, although completely realistic, facilitating cognitive and psychomotor transfer within daily clinical practice and improving behavioral skills in critical situations or in any case of danger. [7,51] The benefits of incorporating specialty-oriented simulation training within medical schools are vast: simulators are capable of providing a highly educational and realistic experience for medical students within a variety of speciality-oriented teaching sessions, suggesting to incorporate simulators into the preclinical and clinical stage of undergraduate medical education. [52] Early clinical contact for medical students in the pre-clinical curriculum, aimed to teach communication skills integrated with practical clinical skills, improves student knowledge, efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.…”

“…For over a decade, in Germany, the Anesthesiology and Intensive Care Medicine Society has stated that centers for teaching anesthesia must be equipped with humansize simulation systems. [7] The basic features for a successful training program that uses human-size simulators are essentially represented by a suitable logistics infrastructure, appropriate materials, participation of instructors with specific training courses, and an instructorstudent ratio as close as possible to the ideal value of 1:3, equivalent to that suggested for correct teaching at the bedside. [40] Typical scenarios of simulation in anesthesia can be represented by common management and daily problems that the specialist anesthetist faces (e.g.…”

“…[4,5] In this context, simulation provides skills and experience in solving specific situations included in a realistic scenario, facilitating the transfer of cognitive, psychomotor and affective capacity within daily clinical practice (in practice, proper communication within the team), thus helping to improve behavior in critical situations. [6,7] Simulation in anesthesia and intensive care (AIC) is a practical method to provide a kind of educational realistic significance for practicing anesthesiologists in order to improve the quality of care and patient safety. In particular, in AIC, simulation is an excellent opportunity to implement those reports of security which can be considered as a real strategy to minimize clinical risk.…”

Tod durch (k)einen Atemweg

“…B. im Sinne von regelmäßigen Hospitationen in der Anästhesiologie oder Teilnahme an praxisorientierten Kursen zur Atem wegsicherung [27,76].…”

Elements of Airway Training

“…However, providing training for these skills on anesthetized patients poses a number of technical and ethical problems. Much work has been done to devise and evaluate alternative teaching methods, such as didactic teaching, videotapes and manikin practice, including simulation, in order to overcome these issues [3,8,9]. Although all of the above-mentioned teaching methods are useful when used appropriately, they do not substitute for experience with real patients under the supervision of expert airway managers [2].…”