Medical Decision Making Under Stress
   Anesthesia Emergency Life Support Course

MODULE I                                                                                                                

            I. Adverse Events and Medical Error in Anesthesiology

                        Complexity and Tight Coupling

                        Latent Errors

                        Predisposing Factors

                        Psychological Precursors

                        Trigger Events

            II. Incident Prevention

                        Dynamic Decision Making

                        Vigilance and Monitoring

                        Validation and Verification

                        Problem Recognition

                        Prediction of Future Status

            III. Stress Management Intervention

                        Stress Inoculation Theory

                        Stress Reaction – Physiological & Psychological

                        Stress Response and Performance

                        Stress Mitigation

MODULE II                                                                                                               

            IV. Anesthesia Crisis Resource Management

                        Available Resources

                        Crisis Management Tactics

                                    Prioritization

                                    Task Load

                                    Vigilance

                                    Anticipation

                                    Re-Evaluate

            V. Anesthesia Emergency Intervention

                        Declaring an Emergency – Assume Leadership

                        ABC Prioritization

                        Adjust – Discontinue Anesthetics

                        Team Communication

                        Action Implementation

                        Fixation Errors

                        Resource Management

                        Re-Evaluation

            VI. Post-Emergency Management

                        Critical Incident Debriefing

 MODULE III                                                                                                                

            VII. Critical Event Management

                        Etiology

                        Typical Situations

                        Prevention Measures

                        Presentation and Manifestations

                        Differential Assessment

                        Medical Management

                        Complications

                        Outcomes

MODULE IV                                                                                                               

            VIII. Critical Events

                        Airway Emergencies

                                    Can’t Intubate

                                    Can’t Ventilate

                        Breathing Emergencies

                                    Oxygenation

                                    Ventilation

                                    Bronchospasm

                                    Laryngospasm

                                    Pneumothorax

                                    Pulmonary edema

                        Circulatory Emergencies

                                    Anaphylaxis

                                    Arrhythmias

                                    Arrest – Cardiovascular Collapse

                                    Hemorrhage

                                    Infarction / Ischemia

                                    Shock

                        Differential Emergencies

                                    CNS Toxicity                                  

                                    DKA – Hypoglycemia

                                    Malignant Hyperthermia

                                    Transfusion Reaction

                                    Seizures

                        Equipment – Environment emergencies

                                    Anesthesia Machine Failures

                                    Electrical Failure

                                    Fire

                                    Gas Supply Failure

                                    Vascular Access Failure – Infusion Failure

                                    Ventilator Failure

MODULE V                                                                                                                

            IX. Simulation Exercises

                        Scenario Management

            X.  Debriefing and Review

MODULE VI                                                                                                               

            XI. Performance Assessment

                        Simulation Case Scenarios

            XII. Course Evaluation

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