Simulation Training for In-Flight Medical Emergencies Improves Provider Knowledge and Confidence

Abstract

INTRODUCTION: In-flight medical emergencies require healthcare providers to operate in confined spaces with limited resources and delayed access to definitive care. These emergencies are common, with an estimated frequency of 1 per 100 to 1000 flights. Despite this, training for medical response in these environments is limited. We hypothesize that integrating such education into a pre-existing medical student elective course would improve knowledge and ability to respond appropriately to in-flight medical emergencies.METHODS: The available literature surrounding in-flight medical emergencies was reviewed. Syncope, respiratory distress, allergic reaction, and cardiac arrest were identified as common and potentially life-threatening complaints. Simulation cases were designed for each of these complaints and a simulation room was modified to mimic an airplane cabin. These simulation cases and accompanying relevant didactic lectures were incorporated into an existing wilderness and extreme environmental medicine course, with multiple-choice tests completed by the students at the beginning and end of the 2-wk course.RESULTS: Participating in this study were 18 students. The pretest average was 76%, which improved to 87% on the posttest. Qualitative feedback regarding this type of training was overwhelmingly positive.DISCUSSION: Simulation-based training for in-flight medical emergencies can significantly improve medical students’ knowledge. This training was very well received by the students. Opportunities for training to manage in-flight medical emergencies remain limited; incorporating such training into existing curricula could provide a means by which to improve provider knowledge. Such a curriculum could be adapted for use by flight crews and other populations.Padaki A, Redha W, Clark T, Nichols T, Jacoby L, Slivka R, Ranniger C, Lehnhardt K. Simulation training for in-flight medical emergencies improves provider knowledge and confidence. Aerosp Med Hum Perform. 2018; 89(12):1076–1079.

A First-Class Simulation: In-Situ In-Flight Medical Emergencies Curriculum for Emergency Medicine Residents Aboard a Commercial Airliner

“…Previously published in-flight medical emergency simulation scenarios were held in a dedicated simulation center or educational facilities [7][8][9][10][11]. One utilized a critical actions checklist for performance assessment but did not report these results [7].…”

“…Approval of residency and clinical leadership ensured that residents had protected time off from clinical duties. Learning station topics were chosen based on the possible need for flight diversion, frequency of reported in-flight occurrence [1,10], or if they were high-acuity pathologies that may be treated with equipment or medications commonly available on commercial in-flight medical kits. Five simulation-based learning stations included anaphylaxis, shockable rhythm arrest, syncope secondary to pulmonary embolism, anterior epistaxis, and an agitated passenger.…”

“…Previous publications of in-flight medical emergencies described individual simulation scenarios [ 7 , 8 ], a curriculum for medical students consisting of a lecture and a simulation scenario [ 9 ], a simulation-based curriculum for medical students participating in a wilderness and extreme environmental medicine elective [ 10 ], and use of a mobile phone application for assistance with management of in-flight medical emergency scenarios [ 11 ]. These educational interventions were held in standard simulation settings.…”

Aging-simulation experience: impact on health professionals’ social representations

“…Simulation-based medical teaching and learning has significantly expanded in recent years. The impact of procedural simulation techniques, on quality of care, in obstetrics [7] and emergency care [19,25,26], has been widely demonstrated. However, in geriatrics/gerontology, aging-simulation experience was not sufficiently studied.…”

In-Flight Emergency: A Simulation Case for Emergency Medicine Residents

“…The use of simulation to recreate a medical emergency on an airplane has proven effective in teaching the medical knowledge required to respond to an in-flight emergency. 4 Additionally, Pettit and Ferguson have published a case in MedEdPORTAL demonstrating the use of a simulated in-flight emergency as a team-building exercise. 5 Successfully managing a complex in-flight emergency requires both adequate medical knowledge and effective teamwork skills.…”