Success Story: Update on Interdisciplinary ED In Situ Simulations

Recently we featured the work of three emergency room physicians – Dr. Matthew Carere, Dr. Ross Hooker, and Dr. Donovan MacDonald – in spearheading an interdisciplinary in situ simulation project. The simulation exercises have continued over the past year and have yielded valuable insights into practice changes, equipment overhauls, and new strategies for communication between team members.

Those engaging in the simulation exercises know there is always a chance they will have to use these lifesaving techniques on a real patient – indeed, that is the expectation. Yet few expect the simulation to be so closely followed by the real patient, as was the case with a recent resuscitation of a premature 2-week old infant who was in profound shock upon arrival. Dr. Carere reflected on the relationship between the case and the simulations, saying “In no small part to the recent in situ simulations which involved situations very similar to this we were able to respond quickly and efficiently”. He witnessed the clinical team working together to stabilize the patient:

“Picture the ER nurses and PICU nurses working together collaboratively. PICU nursing working on specific pediatric medications, IV access and patient care… ER nurses were managing the room, handling IV access, getting medications, fluids, ordering x-rays etc. The patient quickly received multiple fluids boluses, boluses of D10, antibiotics and vasopressors within 25 minutes of arrival in a room that was calm and orderly.

Picture the PICU MD and the ER doc intubating the patient together utilizing a pediatric intubation checklist developed by our very own Dr. Jeff Bishop; implemented and practiced in that same room during our last in situ simulation. It was amazing”.

There is no greater endorsement of the value of simulations than feeling well-prepared to handle the real-life version when it presents itself. The team in the emergency room, along with their colleagues from pediatric intensive care, worked seamlessly to care for this patient, who is now doing very well and is out of PICU.

We congratulate the team for their ongoing efforts in translating these simulations into excellent clinical care.



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