RESUMEN
Tracheo-innominate artery fistulas are a rare complication of indwelling tracheotomies with a very high mortality rate. Due to the rare occurrence of this surgical emergency, most medical providers have little to no training or experience in recognizing, stabilizing, and repairing this life-threatening condition. Simulation of rare emergencies helps close knowledge gaps of medical providers at all levels. Although many providers may never experience these emergencies throughout their careers in clinical medicine, it is imperative that they distinguish and apply techniques for temporizing these life-threatening conditions in order to decrease patient mortality. This novel, low-cost, and easy-to-implement simulation is geared towards this goal and has been successfully tested in small group simulations at one academic center in San Antonio, Texas.
RESUMEN
Left ventricular assist devices (LVADs) are implantable mechanical devices that pump blood from the apex of the left ventricle to the aorta in order to assist the forward flow of blood; they are most commonly used as a bridge to transplant for patients with heart failure. As of February 2019, a total of 25,145 patients with ventricular assist devices have been reported in the Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs). As this number continues to grow, more and more of these patients will inevitably be seen in the acute care setting outside of their defined LVAD center. Currently, however, LVAD emergencies represent a high-acuity low-occurrence event with limited opportunities for exposure and mastery for most physicians. Therefore, a growing need exists for emergency care providers to familiarize themselves with these devices and the management of LVAD emergencies. We present a novel model for the simulation of LVAD emergencies created through simple modifications of a Laerdal 3G Manikin.