Our Goals and Objectives
All scenarios: Closed loop communication is key to all critical situations and is stressed throughout all of the scenarios. Participants repeatedly see how improved closed-loop communication yields better outcomes during the simulation.
Local Anesthesia Systemic Toxicity (L.A.S.T): The ultimate goal of this scenario is for the team to deliver the baby within 5 minutes. During that time we look to ensure that proper ACLS/BLS occurs during the attempted resuscitation. At the debrief portion, the anesthesiologist explains the pathophysiology of L.A.S.T and the warning signs that accompany it.
Shoulder Dystocia: The goal is for the MD to not exceed routine axial traction. Use of a force-monitoring newborn mannequin is used to measure the actual force applied. We also afford each learner (nurses and anesthesiologists included) an opportunity to perform a shoulder dystocia delivery and give them real-time feedback on the amount of pressure they are applying. The importance of clear and accurate documentation is always emphasized during the debrief.
Postpartum Hemorrhage: Early recognition of maternal hemorrhage- Both overt and occult bleeding simulations are used to emphasize the importance of early recognition. Participants learn to clue-in on the patient’s complaints, vital signs and clinical presentation. This scenario also gives the team a chance to become reacquainted with the hemorrhage cart and its contents. The team is also evaluated on how quickly they begin fluid resuscitation and invoke the Massive Transfusion Protocol.
Sepsis: We emphasize the importance of the “Golden Hour” and the need to start antibiotics and fluids, specifically 30ml/kg, immediately. The goal is to observe the team initiate the fluids before waiting for a drop in the blood pressure. We also look to see if the team orders serum lactate levels with the initial blood draw.
High Spinal Block: The main goal is that the team recognizes the respiratory compromise and begins supporting the airway immediately. No CPR is required if the team prevents the respiratory arrest from deteriorating into full arrest. Close attention to the patient’s clinical status and proper communication of the vital signs are key. Mistaking respiratory arrest for full arrest can cause harm to the patient.
Managing Eclamptic Seizures: Our goal is to see that the participants protect the patient from self-harm and verbalize the need to start giving medications only if the seizure was prolonged or recurred frequently. Proper management of the blood pressure is also examined and discussed during the debrief portion.
The class was improved throughout the year by making the situations more clinically accurate and eliminating detractors such as irrelevant lab values. The flow from one simulation to the next was improved by using a different room for debriefing. This allowed the participants to focus on the video playback and discuss openly what they felt they had done well and what they felt they had missed. We also adjusted the rotation of the learners so that they were able be involved in different aspects of the patient’s care. Sometimes the physician was the primary O.B. for the patient, other times they were called in emergently to assist with another MD.
The team-building aspect of this class, although hard to quantify, was of extreme value. Doctors and nurses come from different backgrounds and are trained differently. Having them spend 8 hours shoulder to shoulder working through difficult scenarios sheds much light on each participant’s thought processes and allows them to anticipate each other’s next move. Critical situations run more smoothly when the team is cohesive and communicates effectively.
Two Experiences of the Living Well After Cancer Program
Marilyn Franke was diagnosed in December 2009 at 58 years old. She began the program about three months after finishing her radiation treatment for breast cancer. "I didn’t know what to expect and I was concerned it would be more than I could handle as I was still so fatigued from treatment," shared Marilyn.
Samantha Day was diagnosed in January of 2006 at 41 years old. She joined the program a couple of years after cancer treatment for breast cancer. "I have always been physically active, but I was interested in taking the different classes and learning new ways of staying healthy," explained Samantha.
Both ladies felt the camaraderie of the other participants was a huge factor in getting the most out of the program. Marilyn felt, "If others who had more aggressive treatment than I did can do the program, than I can too!" "I loved the laughs we shared while exercising and the trainers made sure that everyone in my group felt connected no matter what their fitness level was," said Samantha. This program is specially designed to work with cancer survivors and is structured to not push participants past their current strength and fitness level. Everyone works at their own pace and not pressured to do activities they don’t want to try. The program offers classes in Zumba, Yoga, Lo-impact Aerobics, Pilates, Aqua and Hooping. Most participants are eager to try all the classes, in addition to the cardio and strength training that is part of the program.
Both Samantha and Marilyn felt the class was very beneficial and would recommend it highly to other cancer survivors. "It really helped with my fatigue, both emotionally and physically. I felt so much better after the program and was able to return to the activities I did before going through cancer treatment. I also thought the trainers were great and very supportive to the group." said Marilyn. Samantha says, "I loved having access to The Claremont Club during the program. My husband came to the club each time I went to class and worked-out in the weight and cardio room, and he also took a few classes. The entire staff was kind and friendly to everyone in the group. I learned so much about health and wellness and nutrition. At the end of the program there was a cooking demonstration and we all got to eat the healthy food after – it was great fun. All cancer survivors should attend this program."
Did this program change their life after cancer? "Yes - it gave me more confidence and brought joy back into my life. It was fun to look forward to going to the classes," shared Marilyn. Samantha agreed, "My focus went back to living my life not focusing on the cancer."
Every Women's Journey
It's a new year, so it's time for a new you. Keeping your heart healthy is just as important as keeping your overall health. Learn how simple exercise can help you accomplish this.
$100 Cardiovascular Screenings
Cardiovascular disease causes more deaths than cancer, respiratory disease, and accidents combined. Risk of stroke and heart attack increases with age, especially after 40 and even more if you smoke, have high blood pressure, or a family history of cardiovascular disease. About one-third of cardiovascular deaths occur before age 75.
A simple $100 screening could save your life.
A healthier future is just a phone call away. Schedule your screening by calling Stead Heart and Vascular Center
$100 Mammogram Program
Mammograms save lives. And, despite recent confusion, the American Cancer Society states that all women—starting at age 40—should have a yearly screening mammogram. The good news is that 92% of screening mammograms detect nothing suspicious. And, more detailed studies find breast cancer in only 2% of women. Which means, for almost all women, peace of mind is only a mammogram away.
And the Breast Health Center at Pomona Valley Hospital Medical Center wants to give every woman access to that peace of mind by offering high-tech digital mammograms at the lowest possible price.
The cost is just $100.
Which is a bargain for women with health insurance with a high co-pay or deductible, or even no insurance at all. Call 909.469.9395 to schedule your appointment at one of our three convenient locations; the Breast Health Center within The Robert and Beverly Lewis Family Cancer Care Center, the Pomona Valley Health Centers in Claremont or Chino Hills.
Peace of mind is just a phone call away, so call today.