This simulation scenario was created as a way to incorporate hands-on exercises into the anesthesia curriculum and to reinforce material learned in the classroom and operating room. The scenario allows anesthesia residents to practice treating patients with perioperative undiagnosed aortic stenosis and its complications. There are two versions of the scenario, which allows the scenario to be repeated for learners who would benefit from a second exposure to this topic. The overiding goals of the scenario are to improve medical knowledge and patient care as well as enhance communication skills among operating room teams and develop attributes of professionalism. This simulation can be easily adapted to most centers with a high-fidelity mannequin. Two full classes of residents have undergone this simulation and have found it to be useful for exposure of weak areas. Even residents who suspected the diagnosis and provided appropriate care found it helpful for reinforcement of key pathophysiological principles. Emergent induction of anesthesia is a common practice. Limited or no information about the patient can make it difficult to provide the best care. Undiagnosed aortic stenosis is a difficult anesthetic, particularly in an emergent situation. This case will help learners understand the pathophysiology of the disease state, and how to plan and execute care.
- Identify signs and symptoms of severe aortic stenosis; outline the hemodynamic goals for induction and intraoperative management of patients with aortic stenosis.
- Performs a complete preanesthetic physical exam. Generates an anesthetic induction plan for a patient with signs and symptoms of severe aortic stenosis.
- Communicates with the operating room team that there is severe hypotension and electrocardiogram changes.
- During the debriefing after the simulation, discuss the importance of leadership and communication among operating room personnel (anesthesiologist, surgeon, resident nurse, surgical technicians) during times of crisis.
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