Working in  a simulated environment  allows learners rehearse skills in their component parts and practice them together

You can practice till perfection any number of times

Can’t do on Live patient

A skill or a scenario

Video debrief

Comb the operation

We find out where the thinking process has to be modulated

Student realizes himself

 Students and Teachers revisit their clinical proficiency & relearn skills

Simulation offers scheduled valuable learning experiences difficult to obtain in real life. 

Renew simulation based accreditation; say AHA 

Renew your empowerment

Managing  high workload  

Trapping errors  

Coordinating under stress  can be taught and practiced

Eg : Physician errors reduced , with prior practice 

Mortality comes down

Morbidity down scaled

Competency enhanced 

The ALS mannequin supports our AHA ACLS Courses and many others courses. It is also used in Mock codes. It has realism while practicing VF or Asystole scenario. This computerized mannquin allows the following to be performed :

• Its software which can be controlled by a Simpad can change the rhythms on an ECG monitor hooked on to it, allowing the students to decipher this and give appropriate defibrillation or cardioversion;

• Airway interventions including advanced airway insertion, BMV bagging, and insertion of airway adjuncts.

• CPR.

• IV line insertion.

These are robust half torso mannquins and deployed in BLS courses for CPR and BMV or Mouth to Mouth ventilation.

Procured at a cost of Rs 3 crores

Skills enrichment and utilization by Departments of Surgery, Surgical GE and Obstetric and Gynaecology:

Allows for safe practice of procedures

Practice and perfection in skills

Assessment of Surgical Skills

Maintenance of Student logs in Laparoscopic Surgical procedures like Cholecystectomy & Appendectomy

Laparoscopic Hysterectomy

Trauma Mannequin is used to simulate team training in Trauma especially in BTLS and ATLS courses

Models of Skin, Arm Face and leg depicting injuries and burns are layered on to the trauma mannequin during Simulation Scenarios

Comes handy during UG and PG teachings during Pulmonology classes,to demonstrate and identify by direct auscultation or audio perception through speakers, different Heart Sounds & murmurs and Lung Sounds and Adventitious sounds

Deployed to simulate and teach normal and abnormal deliveries

Procured at a Cost of Rs 2 crores

Allows for safe practice and perfection of endoscopic procedures:

Bronchoscopy, BAL, Bronchial Biopsy

Upper GI endoscopy

Colonoscopy

Following is a brief write-up and report on training to Jawans of NDRF, carried out on May 4 & 5, 2022, by the Department of Clinical Skills & Simulation, Saveetha Medical College, Chennai.

"We are happy and privileged to submit that we were able to conduct a 2-day workshop on "Capacity Building & Training in life saving Skills" to 100 JAWANs of 04BN,Arakkonam on 04.5.2022 & 05.05.2022.

This was provided with effort and enthusiasm, incorporating the latest technology and teaching methods providing hands-on experience at the Department of Clinical Skills and Simulation of Saveetha Medical College, involving various departments such as Orthopedics, Surgery, Emergency Medicine, Critical Care, Community Medicine and Forensic Medicine.

In addition to BLS provided by the Simulation Center, the skills stations which were manned by faculty from different departments and colleges, through which the Jawans rotated were: Orthopedics Station( Basic First Aid in fractures with bandaging and Splinting), Surgery Station ( BAsic First aid in injuries and Bleeding control), Intraosseous needle access Station, LMA Station (Laryngeal mask Airway), Basic Airway adjuncts OPA[Oro-Pharyngeal Airway], NPA[Naso-Pharyngeal Airway] and BMV Ventilation Station. The stations were supported with adequate supervised hands-on practice following demos and expert-chaperoned video-clippings.

We also acknowledge support of faculty from the College of Nursing and the AHS (Allied Health Services).

We are sure that this training involving enhancement of cognitive knowledge, procedural skills and team dynamics with regular future updates and practice would impact on the positive outcome in future rescue operations and resuscitations carried out by the NDRF in regional and national disasters, wherein NDRF are usually the first responders"

We attach relevant images of the exercise

Non AHA -Basic Life Support & LMA Insertion training for Employees of PARLE AGRO Co Ltd. (Date:9.12.2021)

The staff members were a keen and enthusiastic batch and quickly grasped the Life saving concepts of BLS including CPR for Adult, Child and Infant in Single and multiple rescuer scenarios. They also understood and practiced individually in hands-on stations through simulation, AED(Automated external defibrillator), Heimlich maneuver (Foreignbody obstruction management of the airway) for Adult, Child and Infant in Conscious and Unconscious predicaments. They learnt and acquired skills in airway and breathing components by practicing ventilation through BMV (Bag-Mask-Valve) device, [Synonym Ambu Bag], Pocket Mask and mouth to mouth ventilation. All the Parle Agro staff members also learnt and practiced LMA(Laryngeal mask airway)insertion, a Rescue Airway. They also practiced in batches perfecting their team dynamics, during a factory emergency arrest.

The AHA Instructor course for Faculty & Clinical instructor was conducted at the Simulation center on 27th July, 2021. The faculties took up their AHA accredited BLS course in morning session and AHA accredited ACLS course at afternoon session, mentored by AHA instructors Dr.Shruthi & Dr. Sudakshana

Aims of the course

To equip the participant with necessary knowledge and skills to become an Instructor in an AHA ACLS Provider Course

Objectives of the course

At the completion of the course the participant will be able to:

verbalize logistics be taken care of prior to an AHA ACLS Provider Course

Display sound knowledge in ACLS concepts.

Conduct scenarios in ACLS Core rhythms and Debrief

Conduct Cognitive knowledge appraisal through MCQs

Conduct Skills acquisition appraisal by filling up the checklists provided by AHA during skill assessment

Demonstrate student friendly tact and behavior

Verbalize the hierarchy in AHA administration and roles of course providers and TC (Training Center) faculty

Verbalize files and data to be maintained at the AHA TC (Training Center)

Aims of the course

To impart ACLS knowledge and skills to staff and students in different colleges of HCP (Health Care Professionals), in the University

Objectives of the course

After successful completion of the course, the learner will be able to:

Recognize and initiate the early management of peri-arrest conditions that may result in life threatening cardiac arrest.

Demonstrate proficiency in providing BLS care and high-quality CPR which comprises prioritizing high quality chest compression and early use of a Defibrillator.

Differentiate and recognize ACLS Core cardiac rhythms.

Demonstrate decision-making actions enunciated in ACLS algorithms.

Effectively communicate as a member and a team leader of a resuscitation team.

Appreciate the impact of team dynamics on overall team performance.

Administer appropriate drugs within the ACLS Algorithms.

Initiate Post-Cardiac arrest care in ROSC [Return of Spontaneous Circulation]

Initiate TTM ( Targeted Temperature management) in ROSC

Verbalize the detection and early management of an ACS ( Acute Coronary Syndrome) in a time window of one and a half hours

Verbalize the detection and early management of an a Stroke patient , in a time window of 3 hours

Aims of the course

To train the Medical UG and PG student in manage pediatric emergencies by applied concepts and skills imbibed in the PALS course

Objectives of the course

At the end of the course the student will be able to Perform high quality CPR in a child or Infant

Mange Airway and Breathing in a child or Infant

Provide O2 support using different O2 therapy devices in a child or infant

Manage a child or infant in the different shock predicaments: Hypovolemic, Cardiogenic, Obstructive and Distributive.

Manage a child or infant with rhythm disturbances

Manage a child or infant with precise team dynamics

Calculate drug dose and Defibrillation current in Joules based on child’s weight

Place an IO (intraosseous Line) for fluid resuscitation and Inotropes administration

Use a Broslow’s tape and calculate fluid and inotropes for the child or infant

Curriculum development and implementation

List of courses run by the department:

AHA (American Heart Association) accredited Basic Life Support (BLS) Provider Course

AHA (American Heart Association) accredited Advanced Cardiac Life Support (ACLS) Provider Course

AHA (American Heart Association) accredited

Basic Life Support (BLS) Instructor Course

AHA (American Heart Association) accredited Advanced Cardiac Life Support (ACLS) Instructor Course

AHA (American Heart Association) accredited Pediatric Advanced Life Support (PALS) Provider Course

AHA (American Heart Association) accredited Pediatric Advanced Life Support (PALS) Instructor Course

Arizona University accredited AHLS (Advanced Hazmat Life Support) Provider Course

Arizona University accredited AHLS (Advanced Hazmat Life Support) Instructor Course

American College of Surgeons accredited ATLS (Advanced Trauma Life Support)

Basic Trauma Life Support

Oxygen therapy, Pulse oximetry and capnography

BAM (Basic Airway Management)

Basics of ECG

Basics of ABG

Basic Hemodynamic Monitoring

Basic Mechanical Ventilation

Simulated Course in Clinical Toxicology

The Bridge Course

Description goes here

The Bridge course is a full seven day program for CRRIs prior to their internship to fill the theoretical and practical gaps in their learning through simulation. The curriculum of this program is based on the professional standards and competencies for their residential practice.

It not only provides a solid foundation for the residents before their internship, but also focuses on ethics and professional practice, health assessment and skill mastery

This one week program ensures the residents to be prepared in their medical field by providing them with opportunities to apply theoretical knowledge in simulated clinical settings under the direction, facilitation and guidance of faculty.

Aims of the course

To ensure the residents to be prepared in their medical field by providing them with opportunities to apply theoretical knowledge in simulated clinical settings under the direction, facilitation and guidance of faculty and provide internationally accredited programs such as AHA BLS, ACLS and PALS

Objectives of the course

At the completion of the course the student will be able to

Approach an arrest patient ensuring Scene Safety

Approach an arrest patient and assess responsiveness

Call for help and activate the EMS

Provide High quality CPR in Adult, Child or Infant

Operate an AED

Perform Heimlich maneuver in case of airway obstruction in conscious or Unconscious adult, child and infant

Perform Log rolling of an Unconscious patient

Place an unconscious patient in the Recovery position

Open the Airway by Head tilt Chin lift or Jaw Thrust maneuver

Ventilate a patient using Mouth to mouth ventilation

Ventilate a patient using Pocket mask

Ventilate a patient using the BMV ( Bag mask Ventilation)

Manage a patient landing in any of these algorithms: Bradycardia, Tachycardia, Asystole, VF/VT

Initiate Post-Cardiac arrest care in ROSC [Return of Spontaneous Circulation]

Initiate TTM ( Targeted Temperature management in ROSC

Insert an AdvancedAirway ( ET TUbe; LMA)

Choose and place Airway adjuncts ( OPA & NPA)

Choose appropriate Oxygen Delivery devices

Perform Synchronized cardioversion in an Unstable tachycardia

Place a TCP (Transcutaneous Pacemaker) in an Unstable Bradycardia)

Place a Nasogastric tube

Place a Foley’s catheter

Give safely Im, SC injections

Place a Venflon IV and procure IV access

Access IO( Intraosseous)site & give fluids and vasopressors in failed IV access

Collect Blood sample through vacutainer

Suture an Episiotomy wound

Perform simple suturing and knotting

Perform resuscitation using team dynamics concepts of the AHA

Perform resuscitation of Child or infant suffering in any Shock syndrome: Hypovolemic, Obstructive, Distributive or Cardiogenic

Verbalize the detection and early management of an ACS (Acute Coronary Syndrome) in a time window of one and a half hours

Verbalize the detection and early management of a Stroke patient, in a time window of 3 hours

What content is included?

The content includes the following:

AHA BLS, ACLS, PALS course material

Oxygen therapy devices course material

Videos on Placement of NG tube, Foley’s catheter, Venflon, Blood sampling using Vacutainer, IM, SC injection, Suturing and Knotting,

What educational strategy is adopted?

Through Online Pre-assessments, gaps in the knowledge and skills obtained

Students shown Videos of AHA BLS & ACLS, with pauses to explain and interact and ensure content delivery

Role Plays and Debriefing

Foundation Course on CPR Training with AED Deployment for I MBBS 2020-21- 5th batch

Simulated classes on BLS conducted for First year MBBS 5th batch students during the Foundation course in overview and strengthening CPR and AED concepts for 250 students with 50 Students per batch.

Aims of the course

To train the faculty to teach in the AHA PALS Provider Course

2, Objectives of the course

At the end of the course the participant will be able to

Schedule an AHA PALS Provider Course,

Provide Course materials in advance to all students

Disseminate welcome mail to all students of the AHA PALS Provider Course

Collect online Pre Test results from students

Set aside rooms, mannequins and equipment required for the course

Allocate and ensure quality mentoring in all AHA PALS Provider video and skills stations

Conduct Post test in cognitive component and Skills Stations

Conducts the Rhythm recognition stations, ensuring clarity for all the students

Conducts the Shock recognition and management stations with precision and clarity ensuring resolution of all doubts of students

Provide Quality Debriefing to students after the Scenarios

Verbalize the hierarchy of the administration in the AHA regional and national program

Supervise and guide placement of an IO (intraosseous Line) for fluid resuscitation and Inotropes administration

Guide in use of Broslow’s tape and calculation of fluid & inotropes for the child.

Collect, file, Label and store paperwork for last 3 years required for future AHA audits

Aims of the course

To provide the critical skills needed to treat victims exposed to toxic substances.

Objectives of the course

At the end of the Course the attendee will be able to:

Medically manage HAZMAT incidents

Verbalize the Toxicodynamics and Toxicokinetics of various nuclear, biological and chemical radiological agents

Verbalize Indications and Don a PPE

Verbalize the containment areas in a CBRN disaster area appropriately as Hot, warm and Cold

Learn to approach the Hazmat victim using Poison Treatment paradigm

Learn appropriate Decontamination Procedures

Verbalize appropriate antidotes and dosage

Aims of the course

To provide the knowledge and skills necessary to conduct an AHLS provider Course

Objectives of the course

At the end of te Course the attendee will be able to:

Apply through AHLS website and schedule an AHLS provider Course

Apply through AHLS website and finalize dates and Instructors

receive and Course materials from AHLS and distribute to students in advance of the Course

Verbalize the hierarchy and organization structure in the AHLS program

Ensure Completion of the Online Pre test and compile the results

Display sound knowledge of the content of an AHLS Provider Course

Reserve rooms, AV Equipment and prepare for the Course in advance

Delegate topics and arrange for Videos, PP and Simulated Scenarios for table top exercises

Conduct a Post test Assessment and complete on Line Certification

Aim of the course

This Course is intended to provide Advanced knowledge and skills required to manage patients presenting after a trauma.

Objectives of the Course :

At the completion of the course the participant will be able to:

Attend to Basics: ABC (Airway, Breathing and Circulation)

Placement of advanced airway devices - LMA & ET Tube

Performing Nasotracheal intubation

Access airway deploying Fiber optic airway devices in a difficult airway

Provide C- Spine Immobilization.

Performing Cricothyrotomy in Failed airway/ Compromised airway

Perform Needle insertion in 2 nd intercostal space in Mid Clavicular line on a simulator

Chest tube insertion on a simulated pneumothorax patient

Conduct Primary Survey

Log roll patient during Primary Survey

Conduct Secondary Survey

Deploy Ultrasound in Secondary Survey and rule out Pneumothorax

Perform FAST (Focused Abdominal Sonography in Trauma)

Perform Lung Scan to exclude Pneumothorax

Acquire image of IVC ( Inferior vena cava) and demonstrate IVC Collapse during Inspiration to guide fluid management

Verbalize Fundamentals of Fluid therapy in Trauma

Interpret CT pictures of EDH, SDH and ICH

Verbalize methods to monitor ICP (Intracranial Pressure) and CPP (Cerebral Perfusion Pressure

Aim of the course

This Course is intended to provide basic knowledge and skills required to manage patients presenting after a trauma.

Objectives of the course

At the completion of the course the student will be able to:

Attend to Basics: ABC (Airway, Breathing and Circulation)

Placement of advanced airway devices - LMA & ET Tube

Access airway deploying Fiber optic airway devices in a difficult airway

Provide C- Spine Immobilization.

Conduct Primary Survey

Log roll patient during Primary Survey

Conduct Secondary Survey

Deploy Ultrasound in Secondary Survey and rule out Pneumothorax

Perform FAST (Focused Abdominal Sonography in Trauma)

Perform Lung Scan to exclude Pneumothorax

Acquire image of IVC ( Inferior vena cava) and demonstrate IVC Collapse during Inspiration to guide fluid management

Verbalize Fundamentals of Fluid therapy in Trauma

Interpret CT pictures of EDH, SDH and ICH

Verbalize methods to monitor ICP (Intracranial Pressure) and CPP (Cerebral Perfusion Pressure

Aim of the course

This Course is intended to provide the skills needed to identify and assist patients at risk for developing airway emergencies. Through the use of simulation as a teaching and learning tool, participants are instructed on basic airway anatomy, early detection of airway emergencies and effective implementation of appropriate airway interventions.

Objectives of the course

At the completion of the course the student should be able to:

Develop a systematic approach of teamwork during airway emergencies.

Identify basic airway compromise and implement appropriate treatment.

Demonstrate knowledge of indications for basic airway management.

Demonstrate effective use of equipment needed to effectively manage an airway emergency.

What content is included?

Airway Anatomy (Applied anatomy)

Initial airway assessment

Non-invasive airway management-opening the airway, supplemental oxygen, ventilation

Definitive airway management- Crash intubation, Rapid Sequence Intubation.

Airway Adjuncts

BMV (Bag Mask Valve) Ventilation

Placement of advanced airway devices - LMA & ET Tube

Aim of the course

This Course is intended to provide skills required choose oxygen therapy devices customized to individual patient requirement and understand the principles, benefits and limitations of pulse oximetry and capnography

2. Objectives of the course

At the completion of the course the student will be able to:

Verbalize the indications for Oxygen administration

Identify the different O2 Flow Devices devices

Demonstrate keying in appropriate O2 Volume which can be fed through each device

Verbalize the FIO2 achieved for each device

Verbalize the mechanism of O2 Toxicity and Tissues damaged

Verbalize and differentiate High Flow and Low Flow Oxygen

Describe Oxygen delivery through the Venturi.

Simulate transport of hypoxic patient with Bain’s Circuit.

Differentiate Oxygenation-Alone scenario from Oxygen-PLUS Ventilation scenario

Verbalize the photometric principles behind working of a Pulse Oximeter

Verbalize the uses and limitation of Pulse Oximeter

Verbalize the functioning and differences between Colorimetric capnography and waveform capnography

Verbalize the utility of capnography in CPR (Cardiopulmonary Resuscitation) and ROSC (Return of Spontaneous Circulation)

What content is included?

Oxygen Therapy devices

Capnography

Pulse Oximetry

What educational strategy is adopted?

Small group teaching through didactic lecture using PP Slides and Videos

Simulated clinical scenarios.with Role play and debriefing

Aims of the course

To have a basic understanding of ECG assessment and interpretation to ensure safe and effective care for patients with known or suspected heart diseases.

Objectives of the course

After successful completion of the course, the learner should be able to:

Understand the cardiac anatomy pertaining to the basics of ECG.

Describe the conduction system of the heart.

Identify the 12 Leads of an ECG and describe where these leads are placed and what area of the heart each lead represents.

List out the waves, complexes, segments of a normal ECG rhythm.

Able to calculator Heart Rate

Identify different ECG patterns: Atrial Arrhythmia & Ventricular Arrhythmia, Chamber Enlargement, Conduction Abnormalities [BBB{Bundle Branch Blocks & Heart Blocks}]

Localisation and Staging in Myocardial Infarction, Ischemic heart diseases

Identify ECG Changes in electrolyte abnormalities.

Aims of the course

To interpret ABG abnormalities and plan treatment strategies appropriately

Objectives of the course

At the completion of he course, the student will be able to

Follow the TUFF’s 7 step approach to interpret an ABG report

Able to interpret straightforward and mixed abnormalities

Able to calculate and verify level of compensation

Able to interpret Anion Gap

Able to identify Hypoxia

What content to be included?

The content includes PP slides on ABG

How can content be organized?

PP slides on ABG

Sample ABG srips for interpretation by students

Practicing ABG abnormalities as role play through simulation

Debriefing and consolidating knowledge in interpretation

What educational strategy to be adopted?

This is a PP lecture with

interactive sessions of Simulations and

Debriefing to break the monotony and ease assimilation of an essential ingredient in critical care diagnosis

What are the TL methods to be used?

Soup Bowl

Simulations, supporting and complementing

Didactic PP

How are assessment carried out?

Through online Pre and post assessments which are summative and formative assessments which are weaved into simulation debriefings, conducted in situ.

How are details of the curriculum communicated?

By email

What educational environment is fostered?

To imbibe the magic of ABG interpretation and reckon as to how many lives may be saved by timely interpretation

Aims of the course

To identify immediately and optimize treatment in shock scenarios.

Objectives of the course

At the end of this course, the student will be able to:

Determine the appropriate hemodynamic monitoring for diagnosis and assessment of tissue hypoperfusion.

Describe the correct set up of specific hemodynamic monitors.

Interpret hemodynamic data appropriately for diagnosis and therapy in the major types of circulatory dysfunction.

What content is included?

Identification of different shock scenarios

Non-invasive and invasive methods af analysis of different components of Hemodynamic Monitoring

Targeting adequate tissue perfusion.

How is the content /educational strategy organized?

Video clippings

Power-point

Hands-on on essential USG skills relevant to HM

Role plays through Simulation and debrief.

Aims of the course

To train in basic concepts and operations of Mechanical Ventilation and NIV (Non Invasive ventilation)

Objectives of the course

At the end of the course the student will be able to

Verbalize the indications of Mechanical Ventilation

Initiate ventilation keying in basic settings customized to patient’s weight

Troubleshoot alarms

Wean the patient from ventilator

Perform all the above actions with an NIV

What content to be included?

The content would include:

Web based software where settings on the ventilator may be changed by participant

PP slides on Indications, Alarms and Weaning Practice on ventilator keying in initial settings

How is the content organized?

The content is organized into

PP Slides

Web Page navigation

Simulations using actual ventilator and NIV and a test Lung

What educational strategy is adopted?

Interactive Browsing of web based interactive simulations

Demonstration on the ventilator attached to the computer using a VGA card

PP Didactic lecture

Individual hands on sessions on the ventilator attached to a test lung

Aims of the course

To train the participant to manage victims of Poisons (Chemical, Pharmaceutical, Insecticides, Plant & Animal poisonings) exposure

Objectives of the course

At the end of the course the student will be able to verbalize adequately diagnosis and treatment strategies among the following poisons

Chemical

Pharmaceutical

Insecticides

Plant and animal

What content is included?

The content would include:

INCHEM website (free poison management website) hosted by the IPCS (International program in Chemical safety), a joint organ of the ILO, UNICEF and WHO

AHLS website navigation

PIC websites of WAPIC and AIIMS

PP slides on Toxicology Course

Videos on Selected Poisoning clippings

How is the content organized?

The content is organized into

PP Slides

Web Page navigation

Videos and Simulations

What educational environment is fostered?

In our agrarian country where upto 30 % of admissions in a teaching hospital ICU may be poisons and the clinical management of which may be perfunctorily taught, the students are encouraged to meet this upcoming challenge, in their forthcoming unfolding career, to manage this group of patients effectively

In conjunction with teaching Cardiac Physiology and Physiology of Shock, to the Ist Semester MBBS students, the students have a hands on exposure of Integrated Education, when they practice in teams in trying to resuscitate different shock scenarios in Hypovolemic, Cardiogenic, Obstructive and Distributive shock.

The students attend for 1 hour, during 3 days in 3 batches of 50/batch

In Conjunction with teaching Blood Gas Analysis during Biochemistry, to the Ist Semester MBBS students, the students have a hands-on exposure as Integrated Education, when they practice as teams in trying to resuscitate simulated patients suffering from Metabolic and Respiratory Acidosis. The students attend for 1 hour, during 3 days in 3 batches of 50/batch

Simulated practice on IM,IV & SC injections to MBBS 3rd Semester (2nd,3rd & 4th Sep,2021)

150 Students of MBBS 3rd Semester practiced in the Simulation centre. The modules were: Intramuscular & Subcutaneous injections and IV access. Classes were conducted for 3 days with 50 students in each class. IM injections were practiced on simulations using citrus fruits, and IV access mannequins deployed while teaching IV access. Prior to practice, the students witnessed short videos, where these skills were demonstrated, followed by actual demo by the faculty in the skill stations. After this period of practice, the students were tested on a different days in small groups through the same simulations through OSCE scoring.

Lumbar Puncture in the Simulation classroom to medical undergraduates, Followed by Hands-on to each and every student. This attempt was made to coalesce the actual clinical experience we encounter as clinicians when we see a patient with Meningitis, Meningoencephalitis, Subarachnoid hemorrhages and other abnormalities. This was done to provide the students a picture of what they would have to tackle when they come over to actual clinical practice as interns and beyond. This class was an effort in early Clinical exposure perhaps through a virtual route vetting the recommendations of the NMC.

Simulation in collecting Blood Cultures from a patient presenting in Septic Shock as a component of the 6 hour Bundle in EGDT (Early Goal Directed Therapy), which can bring the mortality down by 15 %, was practiced by mentors of the Microbiology Department as a prelude to providing similar Simulations to to the UG students

: Collaborating with Forensic Medicine, Simulated Toxicology classes were conducted in 3 batches of 50/ batch

Fulfilling its moral obligation in strengthening Chain of Survival in Community, Department of Clinical skills and Simulation has provided CPR Training / BLS to employees of

Hyundai factory

Brixton Apartment residents,

Collaborated with FICCI , while organizing road safety Program in Chennai

Budokai School of Martial Arts

Registrants of OGISSI workshop in Maternity Hospital, Egmore, Chennai

Office of the Registrar, Santhome

These Value added courses conducted by ENT faculties on 6 Saturdays in a year,when Cricothyrotomy, Anterior nasal Packing in Epistaxis , are taught through Videos and Simualtion

Heart and Lung Sounds (Normal & Abnormal) are taught to UG and PG Students of Medical & Nursing colleges, during their Chest Medicine postings through Auscultation Simulator

During Medicine Postings Medicine faculty are able to conduct Simulated Clinical Toxicology Classes to final Year medical Students; These were even continued as one week session even during Covid pandemic 2020

Teaching on a Birthing Simulator, Normal and Complicated Delivery is ongoing

With advent of LapSim, OBGyN PGS and faculty also train in Virtual reality environment operative procedures such as Lap Hysterectomy

Collaborating with the HOD of Radiology department, and with their assistance, all Medical, Nursing and AHS Students, during Basic Hemodynamic Monitoring Courses, are taught, through Simulation on a human volunteer, FAST ( Focused Abdominal Sonography in Trauma), Lung Scan (To exclude Pneumothorax), Heart PLAX View (Parasternal Long Axis ) image acquisition to exclude Cardiac tamponade; Abnormal Pathology is then shown through video

As a prelude to Credentialing our hospital first responders in Triage, decontamination and managing CBRN (Chemical, Biological, Radiological and Nuclear) emergencies, we have organised our Ist Simulated National Conference in CBRN Emergencies and Disaster management on September 9th and 10th 2019

It is now mandatory that all Final Year BSc, Msc, PBSc and NPCC (Nurse Practitioner in Critical Care) students take up their AHA accredited BLS & ACLS Courses during their Internship and prior to graduation. This would enhance their skills and strengthen their CV which would facilitate in securing good Jobs. In addition, routine Simulation based Classes in Hemodynamic Monitoring, ECG, ABG, Basic Airway, Clinical toxicology are also provided

All AHS Students take up their Simulation based BLS, ACLS, ( From 2022, these courses are AHA accredited to select AHS courses such as Critical Care, ER, and OT Technician Courses), Basic Airway, ECG, ABG, Hemodynamic Monitoring and Oxygen Therapy at the Department of Clinical Skills and Simulation

All Ist Year on Postgraduates, regardless of their discipline, take up their AHA accredited BLS and ACLS courses

Post graduates from Surgery, OBGyn alo tarin on the Hi-fidelity Laparoscopic Simulator procured at a cost of Rs 3 crores.

Post Graduates from Pulmonology, Medical GE and Surgical GE schedule their training experiences on the Endo Sim, in which, Broncoscopy, Upper GI endoscopy and Colonoscopy can be practiced and the PGs can save their performance and compare their learning curves. This helps the mentors in formative assessment

Faculty from ophthalmology participated in the national CBRN workshop in 2019, when decontamination of eye affected through toxic spills and ags exposure through Morgan’s Lenses were demonstrated through video.

We are in teh process of procuring Hi fidelity Ophthalmology Simulators to bolster our UG and PG pedagogy

”AETCOM” (Attitude and Communication Module) of the NMC ( National Medical Council) exhorts the medical student to write at least 3 short paragraphs on his/her a)Experience b)Reflection and c)Inference on a clinical exposure

Background

Introducing students to Health care systems and their functioning.

2. Allows students to tag along , observe, gain experience

3. Understand need for collaborative work in health care

4. Importance of each team member

5. Mutual respect

Competencies addressed

1 Demonstrate ability to work in a team of peers and superiors SH (Shows How)

2 Demonstrate respect in relationship with patients, fellow team members, superiors and other healthcare workers SH (Shows How)

Learning experience

When = Professional Year 2 Hours = : 6 ( 4 tag along + 2 hours discussion)

What? Tag along with HCPs (Health care Providers) , observe their work, conduct interview with them and write narrative

Small Group discussion based on students’ experiences, reflections and inferences

What is to be done to work as an integral part of Health care Team

Based on these guidelines of NMC, we at the Simulation Department, sent out a model experience through email, appended below and with a time frame of 15 minutes collected the Student response.

This exercise vindicated the students’ AETCOM exercise and the feedback was superlative as observed in the student inference itself :

The Module: Working as a Team

It was my turn to tag along as per ”AETCOM” (Attitude and Communication Module) of the NMC ( National Medical Council)

Following is a narrative on your Experience based on the happenings in a routine day at the IMCU:

“Once upon a Day in the IMCU”

You will observe the work (of Doctor, Nurse, ICU Technician), conduct an interview at the end of the shift (1 pm) and write a narrative, for at least 3 short paragraphs on your

a) Experience b) Reflection and c) Inference

It was a routine ICU day. I went there to “tag along” as instructed. I had an early breakfast and was there by 7 am.

The morning duty Nurses had arrived and looked fresh and cheerful.The night duty nurses looked tired and couldn't share in the bonhomie and commenced to 'hand over' to their morning duty colleagues who were 'taking over'. This was a protracted process, since handing over was done, not only for the patients but also the registers, equipment and stock books. I ventured to ask one of them, who submitted, that they were awake and attending to emergencies, throughout the night and had not slept a wink.

There were 2 deaths in the night, patients, who were pretty sick and despite CPR had died; one at 3 am and another at 5 am. The bodies were being packed by the ward attendees and I understood the reason now for the wailing in the lobby as I had entered. The ward attenders also formally informed their colleagues who had come over and left.

The morning nurses divided their strength to attend to different rows and started their rounds, checking the temperature, pulse and BP. They were measuring out the urine output, administering drugs, changing the bed sheets and IV lines and suctioning the patients as required. Everybody was working like ants in an ant hill!

I was dumbfounded and was just watching all this even as the interns and PGs who had come over in the morning took their briefing from the night team. I heard that they had to refresh themselves and come back for a morning class on Mechanical Ventilators by the Chief at 11 am. The Assistant Professor arrived by 8 am and started the routine rounds along with the PGs

and interns and a nursing team member. I found that they were not making rounds in a fixed pattern but zigzagging, prioritizing, as to who was more critical and focusing on those patients.

The rounds took 2 hours to complete! Following this, the Chief, one PG and one nurse came over to the counseling room and the attendees of the patient (Husband, wife, parents ,siblings, etc) were called one by one by the security and the condition of the patient was explained to these attendants by the chief in a relaxed but sober atmosphere. The chief kept his calm even when some hostile attendees were rude and suspicious. But this was rare. To these, he put forth the case, and explained what was being done to them in a technologically and humanely optimum functioning environment and the prognosis in a friendly atmosphere. Almost all the attendees were convinced that the best care was being provided and were satisfied, calm and resigned.. The Attendees were also allowed to see the patient, who satisfied themselves as to their loved one’s present health status and the need for ventilators, oxygen, Infusion pumps, DVT prevention devices, feeding protocols etc.

During this period, the other team members were busy, carrying out procedures and weaning attempts from the ventilator on patients who were responding to therapy. I was shuttling between the counseling and the procedures drawn by the gravity and expertise witnessed in both predicaments. I was able to witness an Endotracheal tube intubation but missed out on an USG guided CVP insertion carried out in another part of the ICU. I mentally made a note that I would repair to this fantastic place tomorrow and see that too. By this time, a new case of OPC Poisoning was shifted in from the ER and a section of the team went to attend to that patient.

As scheduled, the academics took over at 11 am, leaving a section of the team to take care of the patients and the Chief used an innovative method of a mechanical ventilator with test lung connected through a VGA card to the big screen in the ICU auditorium (adjacent to the sleeping-in and retiring room of the patient attendees, well provided with couches, toilet, magazines and TV, with a speaker, through which the ICU secretary would announce

periodically to summon the patient attendees) and explained real time, navigation through the

various ventilator knobs and buttons and choose the initial settings for any patient to whom ventilation is being initiated. He said that the next day would be a class on Ventilator graphics.

Time flew and before we knew how, it was time for the shift change and I proceeded to quickly interview the Assistant who was relatively free and then a nurse and an AHS ICU technician, the gist of which I shall tell you!

I also had time to reflect on my remarkable experience today while traveling back home, (It takes an hour to go home from Saveetha) and will recount to you the result of my introspection

A sample inference from a student: ( Oct 8 2021)

Deepthi Mithra:

Experience: the experience at the icu shows that it needs a lot of team workwork and hardwork

Reflection: my reflection is that I want to be part of such team

Inference: in icu the work needs to be divided into each part and addressed.

The Bridge course is a full seven day program for CRRIs prior to their internship to fill the theoretical and practical gaps in their learning through simulation. The curriculum of this program is based on the professional standards and competencies for their residential practice.

It not only provides a solid foundation for the residents before their internship, but also focuses on ethics and professional practice, health assessment and skill mastery

This one week program ensures the residents to be prepared in their medical field by providing them with opportunities to apply theoretical knowledge in simulated clinical settings under the direction, facilitation and guidance of faculty.

Aims of the course

To ensure the residents to be prepared in their medical field by providing them with opportunities to apply theoretical knowledge in simulated clinical settings under the direction, facilitation and guidance of faculty and provide internationally accredited programs such as AHA BLS, ACLS and PALS

At the completion of the course the student will be able to

Approach an arrest patient ensuring Scene Safety

Approach an arrest patient and assess responsiveness

Call for help and activate the EMS

Provide High quality CPR in Adult, Child or Infant

Operate an AED

Perform Heimlich maneuver in case of airway obstruction in conscious or Unconscious adult, child and infant

Perform Log rolling of an Unconscious patient

Place an unconscious patient in the Recovery position

Open the Airway by Head tilt Chin lift or Jaw Thrust maneuver

Ventilate a patient using Mouth to mouth ventilation

Ventilate a patient using Pocket mask

Ventilate a patient using the BMV ( Bag mask Ventilation)

Manage a patient landing in any of these algorithms: Bradycardia, Tachycardia, Asystole, VF/VT

Initiate Post-Cardiac arrest care in ROSC [Return of Spontaneous Circulation]

Initiate TTM ( Targeted Temperature management in ROSC

Insert an Advanced Airway ( ET TUbe; LMA)

Choose and place Airway adjuncts ( OPA & NPA)

Choose appropriate Oxygen Delivery devices

Perform Synchronized cardioversion in an Unstable tachycardia

Place a TCP (Transcutaneous Pacemaker) in an Unstable Bradycardia)

Place a Nasogastric tube

Place a Foley’s catheter

Give safely Im, SC injections

Place a Venflon IV and procure IV access

Access IO( Intraosseous)site & give fluids and vasopressors in failed IV access

Collect Blood sample through vacutainer

Suture an Episiotomy wound

Perform simple suturing and knotting

Perform resuscitation using team dynamics concepts of the AHA

Perform resuscitation of Child or infant suffering in any Shock syndrome: Hypovolemic, Obstructive, Distributive or Cardiogenic

Verbalize the detection and early management of an ACS (Acute Coronary Syndrome) in a time window of one and a half hours

Verbalize the detection and early management of a Stroke patient, in a time window of 3 hours

What content is included?

The content includes the following:

AHA BLS, ACLS, PALS course material

Oxygen therapy devices course material

Videos on Placement of NG tube, Foley’s catheter, Venflon, Blood sampling using Vacutainer, IM, SC injection, Suturing and Knotting,

What educational strategy is adopted?

Through Online Pre-assessments, gaps in the knowledge and skills obtained

Students shown Videos of AHA BLS & ACLS, with pauses to explain and interact and ensure content delivery

Role Plays and Debriefing