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Critical Lessons in Care


 

GRAPEVINE, Texas – Hospitalist Gilbert Asomaning, MB, ChB, walked into a post-anesthesia care unit (PACU) this morning and was confronted with a 55-year-old male in shock. The monitor presented a myriad of issues: He was making lactate, had trouble urinating–and the familiar PACU beeping was incessant.

But no one knew why. Colleagues screamed out questions: Is he responsive? How are his extremities? Is he on oxygen? Still, the cause of what turned out to be hypovolemic shock was a mystery until someone said it: a pinned iliac artery. The case wasn't real; it was a simulation that was part of an HM11 pre-course at the Gaylord Texan Resort & Convention Center. But the value of the daylong session, "Advanced Interactive Critical Care," was quite real.

"This is a great session...it seems like the real thing, but here you know, you are hear to learn," says Dr. Asomaning, who has been to previous SHM meetings, but this year trekked out a day early from Capital Medical Center in Olympia, Wash., specifically to attend the critical care pre-course. "You go through it and when you make your mistakes, you are corrected. And then you sort of reorganize things in your mind again and you are more prepared when the real thing happens."

The simulation was led by course co-director Kevin Felner, MD, of New York University School of Medicine, who says supplementing lectures with hands-on situations is key to increased comprehension.

"Most people are learners by doing…and learn more from doing something than 45 minutes of lecture with a chalkboard," he says. "We push people, take them out of their comfort zone. That’s how you learn."

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