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Introduction: An important part of anesthesia management is opening and maintaining the patient's airway. Failure to establish and maintain a safe airway for patients during anesthesia is a life-threatening condition. Despite advances in science and technology, difficult airway management is far from ideal. Providing a simulated environment for critical situations seems to be the best way to better educate and prevent medical errors. This study aimed to compare the effect of the FIRST2ACT (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trend) model on knowledge and practical skills of difficult airway management and respiratory accidents between the intervention and control groups. Methods: This study was a quasi-experimental intervention with before and after design. Sampling was done by census method and the participants were third and fourth-year nurse anesthesia students (n=62). The students were randomly allocated to an intervention group (n=31) educated and practicing based on the FIRST2ACT model and a control group (n=31). The intervention consisted of five stages: developing core knowledge, assessment, simulation, reflective review, and performance feedback, all based on the FIRST2ACT model. Theoretical and practical skills were examined in the participants. Data collection tools included a questionnaire and a checklist. Results: The results showed that after applying the FIRST2ACT model, the intervention group scored higher than the control group in both theoretical knowledge (17.87±1.43 vs. 12.67±1.35) and practical skills (134.28±3.21 vs. 81.58±8.55). This difference in results between the two groups was statistically significant (P<0.001). Conclusions: It can be concluded that using this model was effective to improve the knowledge and practical skills of nurse anesthesia students in the field of difficult airway management and respiratory accidents during anesthesia.
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Introduction: Simulation-based interprofessional education (IPE) provides the basis for the necessary competencies for interprofessional collaboration. This study aimed to examine the effects of this educational approach on anesthesia students' attitude and teamwork. Methods: This quasi-experimental study was performed on 72 anesthesiology residents and nurse anesthesia students consisting of 36 participants in the intervention and 36 in the control group. The intervention group participated in a simulation-based interprofessional season, including three scenarios in the induction phase of anesthesia. The control group received routine education. We used the Readiness for Interprofessional Learning Scale (RIPLS) to measure attitude and the KidSIM Team Performance Scale to assess teamwork. The data were analyzed by Analysis of Covariance, paired T-test, Chi-square, and Fischer's exact test in SPSS software, version 22. Results: Comparing post-test scores by ANCOVA showed a significant difference between groups (p=0.001) because there was a significant positive change in the overall attitude score in the intervention group after receiving simulation-based IPE. Regarding the quality of teamwork, the intervention group's scores in all three sub-scales changed significantly after intervention (p<0.05). Conclusions: The simulation-based IPE is recommended to promote a teamwork culture and train empowered anesthesia professionals.
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BACKGROUND: Acute respiratory distress syndrome (ARDS) treatment is based on supportive care such as mechanical ventilation, prophylaxis of stress ulcer, prophylaxis of deep vein thrombosis (DVT), nutritional support, and treatment of underlying disease. OBJECTIVES: We aimed to investigate the effects of nebulized heparin on weaning off intubated ARDS patients admitted to the intensive care unit (ICU). METHODS: In this double-blind clinical trial study, 60 patients with ARDS receiving routine care according to the ARDS protocol were randomly assigned into two groups: intervention group (receiving nebulized heparin 5000 u/BD for one week) and control group (receiving nebulized sterile water 2 cc/BD for one week). The respiratory index (PaO2/FiO2), pulmonary shunt percentage (measured by ABG), tidal volume, minute ventilation, admission duration in the ICU, and days of mechanical ventilation required were recorded for each patient for one week. RESULTS: There was no significant difference in demographic data between the two groups. Inhaled heparin in patients with ARDS could significantly increase the respiratory index (PaO2/FiO2) and decrease pulmonary shunt percentage, minute ventilation, and tidal volume. It also significantly reduced the number of admission days in the ICU and the need for mechanical ventilation. CONCLUSIONS: The result of the present study showed that inhaled heparin in intubated ARDS patients admitted to the ICU improved respiratory and pulmonary status and reduced the need for mechanical ventilation and admission days in the ICU. Nebulizing heparin, as an anti-inflammatory and anti-coagulant agent, is an effective and safe medication for ARDS patients on mechanical ventilation.
