Volume 7, No. 1 • Spring 1992

Simulators Enter the PACU

Two teams developing anesthesia simulators at Stanford University and the University of Florida are now collaborating under a grant from the Anesthesia Patient Safety Foundation to introduce into the post-anesthesia care unit (PACU) simulator-based training focused specifically on safety.

Physicians and nurses in the PACU face both common and uncommon problems similar to those encountered by anesthesia providers in the operating room. Many may involve respiratory and cardiovascular emergencies requiring quick diagnosis and treatment. The two teams, one in California headed by Dr. David Gaba, the other in Florida led by Dr. Michael Good, will meet with their PACU nurses to generate lists of clinical problems encountered in the PACU and then develop simulator scenarios with which to practice the diagnosis and management of the problems.

For example, a typical scenario might simulate a patient who arrives in the PACU responsive and apparently in good condition. Some minutes later the patient suffers a respiratory arrest accompanied by cardiac arrhythmias. Working through the simulation, the PACU personnel are challenged to diagnose the problem, both by analyzing physical signs as well as by interpreting data from the monitors. The PACU personnel m then practice how to initiate the proper emergency treatment and mobilize the necessary help. Such exercises can easily be expanded to include sessions on the proper use and interpretation of monitoring and other instruments, as well as on respiratory and cardiovascular physiology and pharmacology.