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Sundararaj Manou 1 , Biju Cherian 2

Sundararaj Manou 1 , Biju Cherian 2. Dealing with rare but expected complications during procedural sedation: simulation based training. Introduction:

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Sundararaj Manou 1 , Biju Cherian 2

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  1. Sundararaj Manou1 , Biju Cherian2 Dealing with rare but expected complications during procedural sedation: simulation based training Introduction: Sedation is frequently used in the Emergency Department for various procedures. During Year 2 of training, Emergency Medicine Registrars are trained and certified in safe procedural sedation and further develop the skill in their subsequent training. A survey amongst EM Registrars (ST4-6) highlighted the attrition of the skill and a need for a training update on procedural sedation. We describe our experience of a simulation based training aimed to provide training focussed on preparation for procedural sedation and the management of rare but expected complications during procedural sedation. Methods: High fidelity simulation (simman3G) training days in three centres were organised for EM Registrars (ST4-6). Participants were given five scenarios based on safe sedation with varying complexity and constructive feedback was given each time. Pre and post course data was collected and analysed. A follow up ‘change in practice’ survey was done two months later. Results: All of the 26 participants felt the day was useful and over 95% felt they would change practice. In the follow up survey two months later, over 90% of the candidates had changed their practice, thus reducing complications and improving patient care. Conclusions: This simulation based teaching session provided trainees with a refresher session in procedural sedation focussing on preventing and managing complications. The session was appreciated and accepted as an effective way to update sedation skills and practice in a safe environment. The follow up survey confirmed its effectiveness to improve clinical practice. There is growing evidence that patient care and safety can be improved by regular simulation based training programmes1,2. In light of this success we plan to deliver simulation based educational programmes for various grades of EM physicians and also explore the non-technical skills required in clinical practice. • References: • 1.Shavit I, Keidan I, Hoffmann Y, et al. Enhancing Patient Safety During Pediatric Sedation: The Impact of Simulation-Based Training of Nonanesthesiologists. Arch PediatrAdolesc Med. 2007;161(8):740-743. doi:10.1001/archpedi.161.8.740. • 2.Shapiro MJ, Morey JC, Small SD, Langford V, Taylor L, Suner S, Salisbury ML, Simon R, Jay GD. Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum QualSaf Health Care 2004; 13:417-421 doi:10.1136/qshc.2003.005447 1 Specialist Registrar EM & Simulation Fellow, Hull Royal Infirmary 2 Specialist Registrar EM, Hull Royal Infirmary

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