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Simulation brain death scenario for residents: how to create a standardised approach in a multidisciplinary team
  1. Antonio Galzerano1,
  2. Gian Domenico Giusti1,
  3. Fulvio Nisi2,
  4. Federico Marturano2,
  5. Massimo Lancia3,
  6. Mauro Bacci3,
  7. Vito Aldo Peduto2
  1. 1Intensive Care Unit, University Hospital of Perugia, ‘Santa Maria della Misericordia’, Perugia, Italy
  2. 2Anaesthesiology and Intensive Care Unit Department, University of Perugia, Perugia, Italy
  3. 3Section of Legal Medicine and School of Forensic Medicine, University of Perugia, Perugia, Italy
  1. Correspondence to Dr Gian Domenico Giusti, Intensive Care Unit, Azienda Ospedaliera di Perugia, Perugia, 06122, Italy; giandomenico.giusti{at}unipg.it

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Introduction

Brain death is identified with the irreversible cessation of all brain functions. The medical procedures for diagnosis of death are well defined and regulated by Italian laws that give the opportunity to procure organs and tissues1 at the end of observation according to the guidelines of the transplant procurement management.2

Nowadays, there is still a considerable variability in the procurement of organs between different hospitals, which is explained by the different knowledge of the procedure, both technical and non-technical skills, which include the ability of physicians to work together. The simulation technique recreates a scenario that allows successes and mistakes to be experienced, to receive feedback and to gain confidence in a secure environment.3

Materials and methods

We used a simulation manikin (SimMan 3G, Laerdal Medical Corporation), a monitor for displaying vital parameters, a screen for displaying instrumental tests (blood gases, electroencephalogram, imaging) and equipment commonly used in practice resuscitation. From the adjacent ‘control room’ where the technical simulation and tutoring took place, it was possible to supervise the simulation scenario, setting the vital parameters and ‘reactions’ of the manikin in relation to stimulation needs through a special simulation software. The simulation scenario reproposed a clinical case (different for each group of residents) of a frequent abutment pathology in clinical practice. An evaluation commission (or …

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