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Scenario Planning Worksheet
Scenario Off-site Anesthesia: Power Failure
Estimated Scenario Time
Estimated Debriefing Time
Target Group
Prerequisite Knowledge
Learners should possess the following competencies prior to participation in this scenario:
Off-site Procedure module
Cognitive Skills Psychomotor Skills
Brief Summary
Scenario takes place in the CT scanner. The patient is asleep with a CT of the brain underway. All
standard monitors are in place. An 22g IV is in situ. The ACA arrives to relieve the attending
Anesthesiologist for a break. The power goes off.
Learning Objectives
Recognize severity of the situation
Improvise for light sources
Use tactile, visual and auditory senses for monitoring
Ventilate using resuscitation bag
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Scenario Planning Worksheet
Proposed Correct Treatment Outline
Critical Handler
(EVENT LIST)
Event
Call for help
Create alternate light sources (flashlight, laryngoscope light etc)
Use tactile, visual and auditory senses for monitoring
Use manual resuscitator for ventilation
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Scenario Planning Worksheet
Patient Description
Choose Image Name
Age 5 years old
Weight 40 Lbs
Height 36 inches
Gender Female
Background CT for follow up evaluation of VP shunt.
History of Present Complaint
Setting CT scan room. Patient anesthetized and on the ventilator and
monitors.
Patient Information Mild asthma on puffers
History VP shunt for hydrocephalus
Medications Allergy to Sulpha
Allergies
PCP
Show this information on the monitor before starting the scenario
Make this information available during the simulation
Choose Monitor Setup
Monitor Layout
Parameters
Primary ECG CVP AWRR
Secondary ECG NBP CO
Arterial BP TOF TPERI
SPO2 (Pleth) N2O TBLOOD
PAP O2 ICP
CO2 Pulse AGT
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Scenario Planning Worksheet
Equipment Checklist
Equipment that should be readily available for the scenario
Personal
PPE (goggles, gloves, etc)
Stethoscope
Penlight
Reference Material
Diagnostic
BP Cuff Medical Records
Thermometer Physician Orders
SPO2 Monitor and Probe Anesthesia Record
ECG Monitor/Defib/Pacer
Lab Reports
Therapy
Oxygen Source
Oxygen Delivery Adjunct Resuscitative equipment
Suction Laryngoscope blade & handle
IV Start Kit
Crash Cart
Medications & IV Fluids
Propofol
Versed
Fentanyl
Atropine
Ephedrine
Preparation of the Simulator
Mannequin attached to all monitors and anesthetic machine
Number and Roles of Participants
Attending Anesthesiologist
CT technologist
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Scenario Planning Worksheet
Scenario Editor - (Flowchart)
Patient:
Monitor:
Initial State
ECG: 100 BPM, Normal Sinus Rhythm
BP: 100/65
SpO2: 98%
RR: 12
CO2: 29 mmHg
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Scenario Planning Worksheet
Create Physiologic Trends
Trends permit the simulator to physiologically model a number of factors including BP, heart rate, respiration, and other
factors. Use the below tables to plan physiological trends.
(Helpful Hint: Use different colors to identify each parameter)
Trend Name: Time:
Time in Minutes
Value
: : : : : : :
+
+
+
Baseline
-
-
-
Parameters
Heart Rate Central Venous Pressure
Respiration Rate Pulmonary Artery Pressure
SpO2 Pulmonary Artery Wedge Pressure
Blood Pressure Cardiac Output
CO2 Absorbed Oxygen
Temperature Absorbed Nitrous Oxide
Absorbed Anesthetic Agent
Trend Name: Time:
Time in Minutes
Value
: : : : : : :
+
+
+
Baseline
-
-
-
Parameters
Heart Rate Central Venous Pressure
Respiration Rate Pulmonary Artery Pressure
SpO2 Pulmonary Artery Wedge Pressure
Blood Pressure Cardiac Output
CO2 Absorbed Oxygen
Temperature Absorbed Nitrous Oxide
Absorbed Anesthetic Agent
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Scenario Planning Worksheet
Create an Event Handler (Optional)
Events may be customized to initiate an Action such as playing a vocal sound, changing a physiologic value, or inserting a
detailed comment in the Debriefing Log. Use the below table to identify events that trigger an action or frame change.
(Helpful Hint: All critical events should be supported with a detailed comment)
Handler Name: Number of Frames:
EVENTS EVENTS
=================Actions================= =================Actions=================
Power outage occurs: Takes over or instructs another team member to
hand ventilate
ACA calls for help
uses senses to monitor patient (feels pulse, looks at
Finds alternative light source patient color, etc)
EVENTS EVENTS
=================Actions================= =================Actions=================
EVENTS EVENTS
=================Actions================= =================Actions=================
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Scenario Planning Worksheet
Debriefing Overview
Critical Event: Power outage
Rationale: ACA must recognize severity of situation and call for help
Critical Event: Ventilator and monitor failure
Rationale: ACA must think of create sources for light and alternatives to vital sign monitoring and
ventilation
Critical Event:
Rationale:
Critical Event:
Rationale:
Critical Event:
Rationale:
References
Year Reference
2008
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