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LETTERS TO EDITOR
Year : 2021  |  Volume : 22  |  Issue : 1  |  Page : 113-114
 

Mending the after-effects of simulation-based cross-skill airway training during COVID-19 pandemic: The “real” plastic surgery


1 Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
2 Department of Anaesthesiology, Civil Hospital, Fatehabad, Haryana, India
3 Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Date of Submission04-Jan-2021
Date of Acceptance13-Jan-2021
Date of Web Publication22-Feb-2021

Correspondence Address:
Dr. Rashmi Syal
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TheIAForum.TheIAForum_1_21

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How to cite this article:
Syal R, Chander S, Kala PC, Suresh K, Chhabra S. Mending the after-effects of simulation-based cross-skill airway training during COVID-19 pandemic: The “real” plastic surgery. Indian Anaesth Forum 2021;22:113-4

How to cite this URL:
Syal R, Chander S, Kala PC, Suresh K, Chhabra S. Mending the after-effects of simulation-based cross-skill airway training during COVID-19 pandemic: The “real” plastic surgery. Indian Anaesth Forum [serial online] 2021 [cited 2021 May 9];22:113-4. Available from: http://www.theiaforum.org/text.asp?2021/22/1/113/309737




Sir,

COVID-19 was declared a pandemic by the World Health Organization on January 30, 2020, and over the time, many countries observed overwhelmed healthcare facilities that made the crisis even more magnanimous. A strategy to combat the crisis was to increase the critical care capacity in both equipment and workforce. This mandated cross-skill training being imparted to the maximum possible number of healthcare providers with a shared goal of enhancing patient care.[1] It has been found that cross-skill training, especially with the incorporation of simulation-based training sessions, has resulted in better performance in a high-stress environment.[2],[3]

Anticipating overwhelmed systems as per the global trends, the process of simulation-based cross-skill training in airway management was initiated at our institution in April 2020. By this time, our central simulation laboratory was not ready and only one airway management trainer (Ambu, Ballerup, Denmark) was available for the purpose [Figure 1]a. Multiple sessions were planned over a fortnight with a limited number of persons trained daily to keep up with the social distancing norms. The training involved endotracheal intubations using C-MAC video-laryngoscope (Karl Storz, Germany). Attempts by unaccustomed persons exposed the trainer to wear and tear, and it developed multiple tears over the tongue and the pharyngeal walls [Figure 1]b. The issue was discussed with the servicing company, which suggested replacement of the spares though it was not feasible due to the nationwide lockdown with imposed travel restrictions. To keep the simulation-based training continued, it was decided to repair the tears with the help of plastic surgeons. For the repair, continuous sutures were placed with 3-0 silk followed by application of waterproof adhesive, Fevikwik (Pidilite Industries, India) for providing better strength at the repair site [Figure 2]. The result was cosmetically pleasing and functionally satisfying, and no problems were encountered in the further training sessions.
Figure 1: (a) The airway management trainer, (b) the torn parts of the same

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Figure 2: (a) Tongue and (b) posterior pharyngeal wall of the airway management trainer after repair

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While such a way of mending the simulator might not be recommended by the manufacturers, the limitations in the procurement of supplies due to pandemic led to a local solution to the issue.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hedges AR, Johnson HJ, Kobulinsky LR, Estock JL, Eibling D, Seybert AL. Effects of cross-training on medical teams' teamwork and collaboration: Use of simulation. Pharmacy (Basel) 2019;7:13.  Back to cited text no. 1
    
2.
Cannon-Bowers JA, Salas E, Blickensderfer E, Bowers CA. The impact of cross-training and workload on team functioning: A replication and extension of initial findings. Hum Factors 1998;40:92-101.  Back to cited text no. 2
    
3.
Chan A, Nikson C. COVID-19 airway management: Better care through simulation; April 22, 2020. Available from: https://litfl.com/covid19-airway-management-better-care-through simulation/.[Last assessed on 2020 Sep 18].  Back to cited text no. 3
    


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