Mock OR Skit:
Date: April 21st 2016
Location: Kennard-Dale High School
Time: 0700-1245
Duration: 4 hours
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2 hour set up and 45 minutes for tear down
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1 hour and 50 minutes for stations
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20 minutes per station with 2 minutes transition time
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40 minutes for mock OR
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Beginning of April 2016 go to Wellspan York Hospital to arrange supplies in boxes to prepare for transport (See supply list)
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Morning of April 21st 2016 arrive at YH to assist with gathering supplies and loading the SIM man
0700: Arrive at Kennerd-dale to set up mock OR
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Plan:
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Dr. Patterson will run simulation for mock OR
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We will run the OR scene and supply staff
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Staff will include a surgeon, OR nurse, CRNA, and anesthesiologist, and patient
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Lenny Brown - surgeon
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Dave Yantis - patient
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Chris Reynolds on standby/taking pictures
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Lauren Reynolds - CRNA
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Kayla Yantis - Anesthesiologist
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Alex Brown - Pre-operative, intra-op and Post-operative nurse
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Dr. Lowe/Dr. Haas/Professor Burtnett to assist if available
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Set up 5 stations between the auditorium and the library
0900-0915 Auditorium: Will begin with an introduction by Kayla, Lauren and Alex at 0900. This will include a brief background/history of each of us and a description of the CRNA profession. We will then explain the OR skit that we will be presenting.
0915: Begin scenario:
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Scenario: open appendectomy
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Preop interview: involve CRNA, anesthesiologist and surgeon
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Patient (Dave) on stretcher (IV/IVF setup)
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Movement to the OR
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Then will switch to simulation man
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Intraoperative time:
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Place warm blankets
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Run through CRNA routine (meds and antibiotic administration) and intubation
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Patient prep
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Surgeon enters
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Time Out
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Incision
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Intraoperative management from the CRNA standpoint
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Emergence routine and closure
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Awaken patient and transfer to PACU
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Use Dave’s voice for patient
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Post-operative report with CRNA and Post-operative nurse
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Following the scenario we will break students into 5 groups (10 students per group) for the hands on skills sessions. Each session will be 20 minutes long.
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We will then reconvene for final words and questions.
1000-1150 Hands on Stations for Students (2 stations in auditorium and 3 in library):
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Airway X 2: intubation and bag masking (Need two tables)
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Ultrasound
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Vital signs and auscultation of breath and heart sounds (Need 2 tables)
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OR environment (simulator): discuss monitors and drugs used by CRNA and further discuss the profession and role of the CRNA. And answer any questions
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Mock code with CPR and AED (simulator)
1150: Reconvene and departing words
1200: Lunch
Mock OR Skit (0900-0915):
Intro:
Alex, Kayla and Lauren- (welcoming statement and introduction of ourselves; discussion on the CRNA profession; overall plan for presentation; introduction of key roles/staff)
Scene 1: Pre-op Interview
Pt: (In bed, with gown, arm band, IV simulated and IVF hanging)
Surgeon (Lenny): Hi Mr. Yantis, I’m Dr. Brown. I’ll be your surgeon today. I’m going to mark the correct site on your belly to make sure we are all on the same page. (mimics marking site in Right lower quadrant of abdomen). I’ll speak with you after the surgery is done when your more awake to go over how it went. Do you have any questions for me? I’ll have you sign the surgical consent now, which we previously went over the risk and benefits of the surgery.
Pt (Dave): No, I think you covered it. I’m ready to get this appendix out!
CRNA (Lauren): I’m __Lauren____. I’ll be your nurse anesthetist today, working with Dr. Arnold, your anesthesiologist.
OR RN: I’m __Alex______. I’ll be in the OR with you as well.
CRNA (lauren): Mr. Yantis, can you tell us your full name/DOB (checks arm band). And what procedure are you having done today?
Pt (Dave): Dave Yantis, 7/31/86. I’m having my appendix taken out.
(all agree)
CRNA/Anesthesiologist (Lauren/Kayla): pre-op interview, ROS, assessment, consent; “Any questions?, off to the OR, ”
Wheel patient in stretcher to OR.
Scene 2 OR/Transition:
CRNA (Lauren): Intro to OR for patient (cold, move you over to the table, get you comfortable…etc)
Transition Time: Discuss the OR setting with students, they can place OR caps and masks on
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Pt: (sheet placed over head to remove patient from scene as we switch to simulation man)
OR RN (Alex): I’m going to put the stretcher in the hallway. (wheels live pt out of scene; live pt moves to area where he/she can do voice-overs during induction or have patient walk out as we discuss the OR with students)
OR RN (Alex): (return to bedside, facing out to audience, holds pt’s/(sim man) hand, place blankets)
CRNA & Anesthesiologist (Lauren and Kayla): (induction sequence; verbalizing procedures/talking with patient)
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Brief discussion on monitors, preoxygenation, medication administration, and intubation. Discuss turning on vent and taping tube and eyes. (While completing these tasks)
Anesthesiologist (Kayla): (exit after induction)
OR RN (Alex): I’m going to prep the pt now.
Surgeon (Lenny) off to side gowning up; OR RN (Alex) assists with surgical gown & dons sterile gloves; together they place drapes
Surgeon (Lenny): Lets do our final time out.
OR RN (Alex): This is __Dave Yantis. We are doing an open appendectomy. No allergies. Were antibiotics given?
CRNA (Lauren): Yes.
OR RN (Alex): Any concerns from anesthesia
CRNA (Lauren) No
OR RN (Alex): All in agreement?
Everybody: Yes.
Surgeon (Lenny): Making incision now.
Anesthesiologist (Kayla): (comes back in) How’s he doing?
CRNA/Anesthesiologist (Lauren and Kayla): Conversation about progress of patient between each other (VS, ventilation, fluid status)
Surgeon (Lenny): Alright we are closing now.
CRNA/Anesthesiologist (Lauren and Kayla): Begin emergence sequence. (Discussion on emergence while completing tasks: spontaneous respiration, ventilation, rate, narcotic administration, removal of ETT)
Pt (Dave): responds when appropriate to CRNAs questions, extubation (opens eyes and squeeze hand)
OR RN/CRNA (Alex and Lauren): mimic moving pt back onto stretcher; uncover sheet to reveal live pt; sit him up; transfer to PACU
Patient (Dave): Responds sleepy to questions but appears comfortable
Scene 3: PACU/Transition
Explain PACU and its purpose to students
Alex now becomes PACU nurse
CRNA (Lauren to Alex): Report to RN
OR RN (Alex): receives report
Surgeon (Lenny): present for report; “everything went well”
Patient (Dave): Thank you (Sleepy)
1000-1150 Hands on Stations for Students (2 stations in auditorium and 3 in library):
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Airway X 2: intubation and bag masking (Need two tables)
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Ultrasound
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Vital signs and auscultation of breath and heart sounds (Need 2 tables)
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OR environment (simulator): discuss monitors and drugs used by CRNA and further discuss the profession and role of the CRNA. And answer any questions
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Mock code with CPR and AED (simulator)
1150: Reconvene and departing words
1200: Lunch
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