Brief report on combat trauma surgical training using a perfused cadaver model.
Journal
The journal of trauma and acute care surgery
ISSN: 2163-0763
Titre abrégé: J Trauma Acute Care Surg
Pays: United States
ID NLM: 101570622
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
18
4
2020
medline:
5
1
2021
entrez:
18
4
2020
Statut:
ppublish
Résumé
Surgical combat casualty care presents difficult training challenges. Although several high-fidelity simulation (SIM) techniques have emerged, none are able to fully integrate the many intricacies involved in the care of a complex trauma patient. Herein, we report the use of perfused fresh human cadaver model for training and assessment of forward surgical teams (FSTs). Forward surgical teams attend a 4-day combat trauma surgical skills course including focused on trauma exposures. A half-day SIM involves the entire surgical team in four sequential surgical scenarios that involve the neck, chest, abdomen, and extremities, as well as airway management and resuscitation. Teams undergo immediate debriefing and videotape review of team dynamics and technical skills, as well as times to completion of critical interventions. The data evaluated include five initial demonstration courses in which training metrics were available. Each team included both a junior and experienced surgeon, anesthesiologists, and surgical scrub technicians. As FSTs progressed through SIMs, they demonstrated improvements in team dynamics and technical skills evaluations. There was considerable variability in the times to completion of critical intervention, particularly for control of cardiac and vascular injuries. Initial evaluations support the use of this novel perfused cadaver model for the training and evaluation of military FSTs. Preliminary data highlight the utility for open vascular, thoracic, and other high-acuity/low-volume procedures critical to combat casualty care. Larger studies are needed for model optimization and further validation of an objective structured technical assessment tool. Care management, level V.
Sections du résumé
BACKGROUND
Surgical combat casualty care presents difficult training challenges. Although several high-fidelity simulation (SIM) techniques have emerged, none are able to fully integrate the many intricacies involved in the care of a complex trauma patient. Herein, we report the use of perfused fresh human cadaver model for training and assessment of forward surgical teams (FSTs).
METHODS
Forward surgical teams attend a 4-day combat trauma surgical skills course including focused on trauma exposures. A half-day SIM involves the entire surgical team in four sequential surgical scenarios that involve the neck, chest, abdomen, and extremities, as well as airway management and resuscitation. Teams undergo immediate debriefing and videotape review of team dynamics and technical skills, as well as times to completion of critical interventions.
RESULTS
The data evaluated include five initial demonstration courses in which training metrics were available. Each team included both a junior and experienced surgeon, anesthesiologists, and surgical scrub technicians. As FSTs progressed through SIMs, they demonstrated improvements in team dynamics and technical skills evaluations. There was considerable variability in the times to completion of critical intervention, particularly for control of cardiac and vascular injuries.
CONCLUSION
Initial evaluations support the use of this novel perfused cadaver model for the training and evaluation of military FSTs. Preliminary data highlight the utility for open vascular, thoracic, and other high-acuity/low-volume procedures critical to combat casualty care. Larger studies are needed for model optimization and further validation of an objective structured technical assessment tool.
LEVEL OF EVIDENCE
Care management, level V.
Identifiants
pubmed: 32301887
doi: 10.1097/TA.0000000000002737
pii: 01586154-202008002-00026
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S175-S179Références
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