Importância do treinamento de residentes em eventos adversos durante anestesia: experiência com o uso do simulador computadorizado

Domingos Dias Cicarelli; Ricardo Boari Coelho; Fábio Ely Martins Benseñor; Joaquim Edson Vieira

doi:10.1590/S0034-70942005000200001

Scientific Article

Importância do treinamento de residentes em eventos adversos durante anestesia: experiência com o uso do simulador computadorizado

Importance of critical events training for anesthesiology residents: experience with computer simulator

Domingos Dias Cicarelli; Ricardo Boari Coelho; Fábio Ely Martins Benseñor; Joaquim Edson Vieira

http://dx.doi.org/10.1590/S0034-70942005000200001 Braz J Anesthesiol, vol.55, n2, p.151-157, 2005

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Resumo

JUSTIFICATIVA E OBJETIVOS: Em decorrência da grande evolução da monitorização e do arsenal terapêutico disponível nos últimos anos, houve uma redução na incidência de eventos adversos durante procedimentos anestésicos. Porém, continua importante o treinamento dos médicos residentes para este tipo de ocorrência. O objetivo deste estudo foi avaliar o desempenho prático do residente de Anestesiologia em eventos adversos durante uma anestesia simulada. MÉTODO: Foram avaliados 17 médicos em especialização do primeiro e segundo anos de Anestesiologia (ME1 e ME2) e 5 instrutores do Centro de Ensino e Treinamento (CET) do HCFMUSP (Título Superior em Anestesiologia - TSA). Foi utilizado o simulador computadorizado Anesthesia Simulator Consultant (ASC) versão 2.0 - 1995/Anesoft para realização das simulações dos eventos. Os incidentes críticos escolhidos foram fibrilação ventricular (FV) e choque anafilático. Após a realização da simulação, foram impressos os resultados de cada participante e avaliadas e pontuadas as condutas adotadas para resolver os incidentes críticos pré-determinados. Os participantes avaliaram o simulador através do preenchimento de um questionário. RESULTADOS: Não houve diferença estatística entre as médias obtidas pelos grupos, porém notou-se uma tendência de melhor desempenho dos grupos TSA e ME2 na simulação de FV. Com relação ao choque anafilático, houve uma tendência de melhor desempenho do grupo TSA. CONCLUSÕES: O treinamento para diagnóstico e condutas em eventos adversos deve ser foco de atenção durante o treinamento de médicos residentes e na atualização de anestesiologistas. O uso do simulador pode ser uma das formas de realizar o treinamento nestas situações.

Palavras-chave

COMPLICAÇÕES, COMPLICAÇÕES, ENSINO

Abstract

BACKGROUND AND OBJECTIVES: Because of monitoring and drugs evolution, there has been a decrease in the incidence of critical events during anesthetic procedures. Despite this low frequency, critical event training for Anesthesiology residents remains important. This study aimed at evaluating Anesthesiology residents' critical care skills during computer-simulated anesthesia. METHODS: Seventeen anesthesiology residents (first and second year) and 5 anesthesiology instructors were evaluated. Using the Anesthesia Simulator Consultant (2.0 - 1995/Anesoft) simulations of ventricular fibrillation (VF) and anaphylactic reaction (AR) were performed. After simulation, results of each participant were printed and approaches to solve predetermined critical events were evaluated and scored. Participants have evaluated the simulator by filling out a questionnaire. RESULTS: There were no significant differences in means obtained by groups, but there has been a trend toward better performance of second year residents and Anesthesiology instructors during VF simulation. There has been a trend toward better performance of Anesthesiology instructors during AR simulation. CONCLUSIONS: Critical events management training should be the focus during residents and anesthesiologists training. Computer simulation could be a way to carry out such training.

Keywords

COMPLICATIONS, COMPLICATIONS, TRAINING

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Importância do treinamento de residentes em eventos adversos durante anestesia: experiência com o uso do simulador computadorizado

Importance of critical events training for anesthesiology residents: experience with computer simulator

Domingos Dias Cicarelli; Ricardo Boari Coelho; Fábio Ely Martins Benseñor; Joaquim Edson Vieira

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