Venous Air Embolism Curriculum

Abstract

Abstract Introduction Venous air embolism (VAE) may occur suddenly and unexpectedly during various surgical procedures. The factors that determine the severity of a VAE episode depend on the quantity and rate of air entrainment from the surgical field into the venous system. Recognition of a clinical episode of VAE remains a problem for anesthesiologists because the clinical signs are prevalently non-specific, ranging from minor vital sign changes to fatal cardiac collapse. Once recognized, a structured approach should be applied to reduce further air entry, support the circulation, and treat the possible complications. Methods This curriculum is designed for residents to acquire essential knowledge, attitudes, and skills that are required of crisis events involved in VAE management. The scenario included in this curriculum is designed to provide hands-on experience in diagnosis and management of a life-threatening episode of VAE that occurs during a hepatectomy. This scenario is also designed to allow residents to acquire essential knowledge, attitudes, and skills (e.g., teamwork and effective resource utilization) required for crisis events involved in VAE management. Results This curriculum has been tested in five simulator sessions with the participation of 3 residents per session (one CA-1, one CA-2, and one CA-3). We found that the scenario was reliable to meet residents' learning needs and valid in assessing residents' clinical and procedural competence with focus on critical thinking, decision making, and teamwork. From the trainees' perspective, the session was highly appreciated and deemed to be a realistic, challenging, and a positive learning experience. Discussion This scenario successfully increased the residents' knowledge, attitudes, and skills in diagnosis and management of a life-threatening condition that occurs during surgery. The curriculum build-up follows a structured frame designed to be adaptable to different scenarios.

Keywords

• Cardiac Arrest
• Venous Air Embolism
• Sudden
• Crisis Management
• VAE Curriculum
• Surgical Complication