Author Of 3 Presentations
IN SITU SIMULATIONS IN PEDIATRIC EMERGENCY ROOM (PER): RESILIENCY AND TEAM WORK ANALYSIS. ONE YEAR EXPERIENCE.
Abstract
Background
In all critical situations involving children, emotional impact is huge, even for professionals: pediatric emergencies represent a very strong challenge for physicians and nurses.
Objectives
To analyze team working with a special regard to the attitude of different professional figures involved (pediatricians, residents, nurses) with in situ simulation in a PER in a tertiary pediatric hospital.
Methods
We performed, from March 2018 to March 2019, 10 high fidelity in situ simulations involved all the PER team in Udine University Hospital. A team composed of four rescuers (a pediatric consultant, a resident and two nurses) attended monthly a simulated scenario. Five facilitators observed the team in every training situation. Before and after simulation all the participants filled out a questionnaire to explore and measure: 1) self-awareness, 2) resiliency, 3) social skills, 4) sense of responsibility, 5) ability to motivate the group. We also decided to include the psychologist as an actor into each scenario, performing one of the parents.
Results
We performed 10 simulations which included 10 pediatricians, 10 residents and 20 nurses. Simulation improved the technical and not-technical skills especially in residents group. Resiliency pattern resulted increased after the simulation in all groups categories. Simulation implemented mostly the categories “sense of responsibility” and “social skills” across nurses, were higher scores has also been recorded.
Conclusion
Simulation improved the management of both technical and not-technical skills. The questionnaire was a good predictor of self-sense, is quick, reproducible, not operator sensitive and can be applied in further studies.
GLIAL FIBRILLARY ACIDIC PROTEIN PLASMA LEVELS DURING CONGENITAL HEART DISEASE SURGERY AND OVER 24 HOURS POST-SURGERY
Abstract
Background
Background. Neuro-cognitive deficits affect nearly 50% of children with complex congenital heart diseases (CHD). Newly acquired brain injury in CHD children affect 30% postoperatively.
Objectives
Objective. We determined GFAP levels during surgery and for the first 24h after surgery to find out the pivotal timepoint of brain injury during the perioperative period of CHD surgeries.
Methods
Methods. We studied 43 children: 9 univentricular physiology (UNIV); 16 septal defects (SD); 5 transpositions of the great arteries (TGA), 4 tetralogies of Fallot (TOF), and 9 surgical controls. GFAP was measured by ELISA during surgeries and intensive care stay.
Results
Results. In controls, mean GFAP (ng/ml) before, after at least 30 min from anesthesia induction, and after surgery were 0.14 ± 0.05, 0.13 ± 0.05, 0.16 ± 0.07, respectively. In CHD patients all GFAP levels collected during intensive care stay were significantly lower than the maximum GFAP level recorded during cardiopulmonary bypass (CPB): at 6h 0.26 ± 0.16; 12h 0.25 ± 0.16; 24h 0.27 ± 0.17 vs. the maximum GFAP 1.69 ± 1.74 during surgery (p<0.001, Wilcoxon Signed Rank Test). There were no GFAP differences between time points in all children. In 10% of the intensive care samples (4 patients: 1 SD, 1 TOF, 2 UNIV), GFAP reached the supposed cut-off for clinical evidence of brain injury (0.46 ng/ml).
Conclusion
Conclusions. The highest GFAP values were recorded during the CPB run at the end of rewarming rather than in the early post-operative phase. Neurodevelopmental studies are ongoing to correlate GFAP levels to children outcome.
SIMULATE OR NOT SIMULATE: THAT'S THE QUESTION
Abstract
Background
Medical simulation is a tool, device or environment with which the learner experiences a representation of a real event for the purpose of practice and learning.Objectives
Several studies suggest that delayed or aggressive treatments, poor team dynamics and certain human factors are among the most important drivers of poor outcomes during hospitalization.Moreover, especially in acute care, the healthcare professional faces to complex situations and treatments that are also potentially harmful for the patient. The opportunity to learn in a safe environment remains one of the focal points of improvement in healthcare delivery, especially in pediatrics.
Methods
The field of pediatric simulation has grown rapidly in the last years and simulation-based interventions has been conducted for many purposes: education and training assessment, improvement in the quality of care, designing of new equipment, learn crisis resource management (CRM), unit risk assessment, check situation readiness, implement new protocols, improve interdepartmental coordination, learn new concepts or procedural skills.Results
Simulation-based research (SBR) is mainly oriented to assess the effectiveness of simulation as an educational intervention or as an investigative methodology. It provides several opportunities like an easier standardization (patients, environment and intervention) compared to clinical trials but also challenges like a clear and consistently measurable outcome selection, as far as a plausible association to the intervention.Conclusion
Another important remark is the strengthening of educational networks and a common research program for the pediatric simulation community, in order to ensure high-quality SBR and to point out the most meaningful questions in pediatrics simulation research.Presenter of 2 Presentations
GLIAL FIBRILLARY ACIDIC PROTEIN PLASMA LEVELS DURING CONGENITAL HEART DISEASE SURGERY AND OVER 24 HOURS POST-SURGERY
Abstract
Background
Background. Neuro-cognitive deficits affect nearly 50% of children with complex congenital heart diseases (CHD). Newly acquired brain injury in CHD children affect 30% postoperatively.
Objectives
Objective. We determined GFAP levels during surgery and for the first 24h after surgery to find out the pivotal timepoint of brain injury during the perioperative period of CHD surgeries.
Methods
Methods. We studied 43 children: 9 univentricular physiology (UNIV); 16 septal defects (SD); 5 transpositions of the great arteries (TGA), 4 tetralogies of Fallot (TOF), and 9 surgical controls. GFAP was measured by ELISA during surgeries and intensive care stay.
Results
Results. In controls, mean GFAP (ng/ml) before, after at least 30 min from anesthesia induction, and after surgery were 0.14 ± 0.05, 0.13 ± 0.05, 0.16 ± 0.07, respectively. In CHD patients all GFAP levels collected during intensive care stay were significantly lower than the maximum GFAP level recorded during cardiopulmonary bypass (CPB): at 6h 0.26 ± 0.16; 12h 0.25 ± 0.16; 24h 0.27 ± 0.17 vs. the maximum GFAP 1.69 ± 1.74 during surgery (p<0.001, Wilcoxon Signed Rank Test). There were no GFAP differences between time points in all children. In 10% of the intensive care samples (4 patients: 1 SD, 1 TOF, 2 UNIV), GFAP reached the supposed cut-off for clinical evidence of brain injury (0.46 ng/ml).
Conclusion
Conclusions. The highest GFAP values were recorded during the CPB run at the end of rewarming rather than in the early post-operative phase. Neurodevelopmental studies are ongoing to correlate GFAP levels to children outcome.
SIMULATE OR NOT SIMULATE: THAT'S THE QUESTION
Abstract
Background
Medical simulation is a tool, device or environment with which the learner experiences a representation of a real event for the purpose of practice and learning.Objectives
Several studies suggest that delayed or aggressive treatments, poor team dynamics and certain human factors are among the most important drivers of poor outcomes during hospitalization.Moreover, especially in acute care, the healthcare professional faces to complex situations and treatments that are also potentially harmful for the patient. The opportunity to learn in a safe environment remains one of the focal points of improvement in healthcare delivery, especially in pediatrics.
Methods
The field of pediatric simulation has grown rapidly in the last years and simulation-based interventions has been conducted for many purposes: education and training assessment, improvement in the quality of care, designing of new equipment, learn crisis resource management (CRM), unit risk assessment, check situation readiness, implement new protocols, improve interdepartmental coordination, learn new concepts or procedural skills.Results
Simulation-based research (SBR) is mainly oriented to assess the effectiveness of simulation as an educational intervention or as an investigative methodology. It provides several opportunities like an easier standardization (patients, environment and intervention) compared to clinical trials but also challenges like a clear and consistently measurable outcome selection, as far as a plausible association to the intervention.Conclusion
Another important remark is the strengthening of educational networks and a common research program for the pediatric simulation community, in order to ensure high-quality SBR and to point out the most meaningful questions in pediatrics simulation research.Moderator of 7 Sessions
Facilitator Of
*INTRODUCTION, AGENDA AND BRIEFING OF THE DAY
*DELIVERY ROOM PEEP, PRETERM ACCESS, PRETERM AIRWAY MANAGEMENT & LISA
*PRESENTATION OF THE MANIKIN (BRIEFING OF THE SESSION)
SIMULATED SESSIONS 4, 5 AND 6
SUMMARY & CLOSE
SIMULATED SESSIONS 1, 2 AND 3