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Procedures and circumstances can be reproduced for routine events, as well as critical incidences. Not only intraoperative care but also trauma care and cardiac life support can be reproduced in the simulator setting. This allows other departments within the Medical Center to receive training from experts within the Department of Anesthesiology or their respective departments. The UCLA Department of Anesthesiology simulator has been on site since July 1996, making UCLA the first simulation program in Southern California. It is located in the Center for the Health Sciences, where it is used every month for critical incidents sessions for the senior residents. During these sessions senior residents get hands-on experience with complex, infrequently occurring scenarios that they would otherwise only read about. These workshops are limited to three residents per session and are followed by a debriefing, consisting of a review and critique of the videotaped session. New residents in the UCLA Department of Anesthesiology receive training on the simulator before entering the actual OR. During their starting month, new residents participate in four simulator sessions, one each week. The sessions emphasize the technique of induction, emergence issues, management of hypoxemia and management of intraoperative hemodynamic changes. Medical student sessions are held every two weeks for the students on the anesthesiology service, to acquaint them with airway management and assessment of critically ill patients. Oliveview Medical Center, King/Drew Medical Center and the West LA VA Hospital, all UCLA affiliated programs, participate on an ongoing basis in these simulation sessions. Community based physicians interested in participating in CME sessions on the UCLA simulator may call (310) 267-2114 for more information.
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Anesthesia
simulation is the use of a computerized, life-like mannequin to recreate
a patient in a clinical environment. The Human Patient Simulator, representing
the patient, has palpable pulses, audible heart tones, breathes, and can
even talk. This "patient" can be intubated by direct laryngoscopy, or difficult
airway scenarios can be recreated and the appropriate procedures performed.
Physiologic responses to these procedures are monitored on actual patient
care monitors; the response to events may be varied to represent normal
or pathologic responses. Neuromuscular blocking agents can be monitored
by ulnar nerve stimulation. Over 40 medications' pharmacological responses
are modeled. The simulated drugs are administered in standard fashion via
IV tubing after identifying them to the simulator by scanning their label.
Ventilation is performed with either an anesthesia machine or a standard
ventilator while pulmonary gas exchange and mechanics are monitored in
standard fashion.
