Arterial blood gas changes during cardiac arrest and cardiopulmonary resuscitation combined with passive oxygenation/ventilation: a METI HPS study

Objective High-fidelity simulators can simulate physiological responses to medical interventions. The dynamics of the partial arterial pressure of oxygen (PaO2), partial arterial pressure of carbon dioxide (PaCO2), and oxygen pulse saturation (SpO2) during simulated cardiopulmonary resuscitation (CPR) were observed and compared with the results from the literature. Methods Three periods of cardiac arrest were simulated using the METI Human Patient Simulator™ (Medical Education Technologies, Inc., Sarasota, FL, USA): cardiac arrest, chest compression-only CPR, and chest compression-only CPR with continuous flow insufflation of oxygen (CFIO). Results In the first period, the observed values remained constant. In the second period, PaCO2 started to rise and peaked at 63.5 mmHg. In the CFIO period, PaCO2 slightly fell. PaO2 and SpO2 declined only in the second period, reaching their lowest values of 44 mmHg and 70%, respectively. In the CFIO period, PaO2 began to rise and peaked at 614 mmHg. SpO2 exceeded 94% after 2 minutes of CFIO. Conclusions The METI Human Patient Simulator™ accurately simulated the dynamics of changes in PaCO2. Use of this METI oxygenation model has some limitations because the simulated levels of PaO2 and SpO2 during cardiac arrest correlate poorly with the results from published studies.

Human Patient Simulator based CBRN Casualty Management Training

<p>Chemical, biological, radiological and nuclear (CBRN) emergency are becoming an impending threat. Effective preparedness needs to be raised for prompt response of CBRN incidents. During mass casualty incidents the strategy of the first responders must be beyond the triage, evacuation and medical first aid. Response process is advanced by the presence of CBRN contaminants and it becomes more complex when the rescue operations have to be performed immediately after the incident. Methodological approach is required to identify and decontaminate the CBRN victims. To manage CBRN emergencies, skill based training of appropriate degree is a key to the right level of preparedness. Intervention by first responders requires specialised inputs in knowledge, skills and aptitude. In India, CBRN defence training has traditionally been a military oriented domain, involving the quick reaction team, quick reaction medical team, rapid action medical team, etc. The training concept discussed in this study contemplates around standardised simulated CBRN casualty referred to as CBRN human patient simulator (HPS), which conceptualised in the division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi. HPS provides an opportunity to learn about the health impact of CBRN contaminants and practise medical management. Simulation as training and planning tools, offers repeatability, controllability, possibility for evaluation and provides a platform to learn from costly mistakes. Group training and demonstrations conducted on the HPS offers an additive benefit to enhance performance as a team and also help to reduce errors. This paper provides the information on the potentials of simulation based training of emergency response teams in the management of CBRN victims.</p><p> </p>