Medical simulation in paediatric anaesthesia

Abstract

Paediatric anaesthesia presents unique challenges. Highrisk patients, premature babies, neonates, infants, small toddlers and children with multiple congenital anomalies are included in this group of patients. Infants and neonates are more at risk of an adverse incident perioperatively and also suffer higher morbidity and mortality than older children. Centralisation of tertiary paediatric services and reduced working and training hours present a challenge to the training and maintenance of paediatric anaesthesia skills. In many countries, paediatric emergencies and surgery are often managed outside tertiary paediatric centres. The provided care may be given by doctors and nurses who only have occasional exposure to paediatric patients. The care of paediatric patients involves anaesthetists and competent medical and nursing support in the perioperative period. Medical simulation creates a realistic, safe and reproducible setting or environment that represents a clinical scenario for medical training. Medical simulation utilises standardised patients, a computer-based system, part-task trainers and full-body mannequins. Full-body paediatric mannequins, available in neonatal, infant and child sizes, have realistic vital signs and clinical features, airways (tongue swelling and stridor), breathing patterns and sounds, cardiovascular characteristics (heart sounds and murmurs), and other signs such as abdominal distension, seizures and bulging fontanelle. These mannequins can be intubated and cannulated (intravenous and intraosseous) and can have chest tubes inserted. Clinical feedback on treatment and interventions facilitates an immersive clinical experience for participants.