SALAD TRAINING
The development of simulation centres has improved the level of teaching available in Surgery and also Anesthesia. There are 2 steps involved in this innovation: First to expose students of all experience levels to consistent training scenarios. then Secondly to begin testing retention of material known to be necessary for competent application.
Specific problems are identified such as difficult airway , airway fires, equipment malfunction and other "imagined difficulties" and then a teaching approach is constructed to teach management. The development of vomiting during attempts to intubate is one of the most challenging events one can encounter. The vomiting manikin recently popularized by great airway innovator from Milwaukee Dr Jim Ducanto and by Dr Yen Chow of Thunder Bay EMS service is a remarkable addition to simulation centre teaching capability.
Using these manikins is surprisingly instructive because one can learn to aggressively attack the appearance of vomitus and control the situation quickly to avert disaster. The first realization is that quick action is effective, the rapid suctioning followed by placing the suction on the left side of the laryngoscope can permit one to focus on getting the view and then placing an endotracheal tube. The Video Laryngoscope is effective in these situations because the elevation of the tongue allows fluids to collect in the back of the pharynx whereas the direct laryngoscope creates a channel that narrows as it gets closer to the larynx with the result that fluids collect at the critical spot essential for visualization. Many opinions will emerge on this point but I am confident that Video will prevail. This is apparent with the vomikin manikins.
1. The vomiting Manikin pump and reservoir in place prior to teaching.
The development of simulation centres has improved the level of teaching available in Surgery and also Anesthesia. There are 2 steps involved in this innovation: First to expose students of all experience levels to consistent training scenarios. then Secondly to begin testing retention of material known to be necessary for competent application.
Specific problems are identified such as difficult airway , airway fires, equipment malfunction and other "imagined difficulties" and then a teaching approach is constructed to teach management. The development of vomiting during attempts to intubate is one of the most challenging events one can encounter. The vomiting manikin recently popularized by great airway innovator from Milwaukee Dr Jim Ducanto and by Dr Yen Chow of Thunder Bay EMS service is a remarkable addition to simulation centre teaching capability.
Using these manikins is surprisingly instructive because one can learn to aggressively attack the appearance of vomitus and control the situation quickly to avert disaster. The first realization is that quick action is effective, the rapid suctioning followed by placing the suction on the left side of the laryngoscope can permit one to focus on getting the view and then placing an endotracheal tube. The Video Laryngoscope is effective in these situations because the elevation of the tongue allows fluids to collect in the back of the pharynx whereas the direct laryngoscope creates a channel that narrows as it gets closer to the larynx with the result that fluids collect at the critical spot essential for visualization. Many opinions will emerge on this point but I am confident that Video will prevail. This is apparent with the vomikin manikins.
1. The vomiting Manikin pump and reservoir in place prior to teaching.
2. The Clinical setup with the emergence of Pseudo Vomit.
3. The fluid challenge is seen with a suction in place on the left side of the mouth while the VL and tube are utilized. The continuous suction maintains a dry field.
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