A Hemodynamic Monitor as a Simulation Tool, a Novel Use of the PiCCO2: Technical Description of the Method and Its Application.

Abstract

The PiCCO2 is a commonly used monitor, which education remains theoretical and demonstration based. Simulation allows active learning, which may help achieve a better understanding and handling of this device, hence a safer and more effective use. Because of the lack of availability of dedicated simulators and the uselessness of the demonstration mode of monitors for simulation purpose, simulation remains seldom used. We will describe a novel use of the PiCCO2 for simulation training and its experiment in high-fidelity simulation (HFS). A standard PiCCO2 was modified with software allowing its transformation into a simulator. The values displayed on the screen were managed in real time by an operator using a standard laptop linked to the monitor and using a standard disposable catheter set to execute simulated transpulmonary thermodilution. Nineteen volunteers were requested to assess the realism of the device during scenarios in which the PiCCO2S (simulator) was used in an HFS environment, with a mannequin reproducing a septic shock condition. Two experimental sessions were made. PiCCO2S was used in the contextualized setting of HFS, which allowed a good interactivity between the device and its users. Participants had a positive perception of the realism as well as the method's adequacy to achieve a better understanding of the PiCCO2. The PiCCO2S could be obtained from a serial device. Its integration in HFS provided a realistic handling of the device. A built-in simulation mode into serial medical devices may give users an easy access to training.