Simulation Hands-On Sessions

Thoracic Ultrasonography for the Pulmonary Consultant – Simulation Demonstration

Learning Objectives

  • Understand the knowledge base required to perform thoracic ultrasonography and interpret cases.
  • Integrate general thoracic ultrasonography with other radiography modalities.
  • Incorporate interpretation skills required for thoracic ultrasonography.
  • List appropriate uses of thoracic ultrasonography practices.

Thoracic ultrasonography is a noninvasive and readily available imaging modality that has important applications in pulmonary medicine outside of the ICU. It allows the clinician to diagnose a variety of thoracic disorders at the point of care. Ultrasonography is useful in imaging lung consolidation, pleural-based masses and effusions, pneumothorax, and diaphragmatic dysfunction. It can identify complex or loculated effusions and be useful in planning treatment. Identifying intrathoracic mass lesions can guide sampling by aspiration and biopsy. Image interpretation will be performed through review of cases with live audience response interaction from learners.

Paru Patrawalla, MD, FCCP
Lewis Satterwhite, MD, BA, FCCP
Kenneth Lyn-Kew, MD
Ariel Shiloh, MD, FCCP

Advanced Critical Care Echocardiography – Simulation Demonstration

Learning Objectives

  • Review the image set of advanced critical care echocardiography.
  • Understand the measurement of stroke volume and its derived values.
  • To assess left ventricular function.

The session will provide an overview of advanced critical care and then focus on a useful application: the measurement of stroke volume and its derived values. A brief introduction and demonstration of the essentials of echocardiography will be provided and discussed, followed by an in-depth demonstration of the measurement of stroke volume. Lastly, expert faculty will discuss stroke volume and advanced critical care echocardiography, and answer questions of learners.

Paul Mayo, MD, FCCP
Gulrukh Zaidi, MD, FCCP
Yonatan Greenstein, MD, FCCP

Managing Acute Respiratory Failure in Special Populations – Simulation Demonstration

Learning Objectives

  • Provide an approach to the management of patients with acute respiratory failure and severe neurological emergencies.
  • Provide an approach to the management of patients with acute respiratory failure and severe congestive heart failure and hemodynamic instability.
  • Provide guidance to the management of patients with acute respiratory failure who have traumatic injuries.
  • Develop a framework to care for the pregnant patient with acute respiratory failure

 This session will build on principles of mechanical ventilation in the care of patients with acute respiratory failure in the setting of cardiovascular/cardiothoracic, neurological/neurosurgical, pregnancy, and other unique populations that might not be commonly encountered for intensive care clinicians working in traditional medical ICUs. This course will focus on clinical decision-making using ventilator graphics, clinical clues, and other methods to address these unique populations. Conventional and non-conventional methods will be highlighted based on the evidence-based literature.

Viren Kaul, MD, FCCP
Brady Scott, PhD, RRT, FCCP
Jaspal Singh, MD, FCCP

Ventilator Graphics: “Fix the Vent” – Simulation Demonstration

Learning Objectives

  • Interpret ventilator graphics and waveforms encountered during routine care.
  • Utilize graphic interpretations to solve clinical problems.
  • Understand the various types of ventilator asynchrony.

This simulation-based session will focus on the understanding and management of ventilator graphics in the routine care of ICU patients. Faculty will provide brief clinical vignettes followed by video demonstration of ventilator graphics. The audience will then choose a response through polling software. This will be followed by an explanation of the correct answer and faculty comments of clinical correlations.

Neil MacIntyre, MD, FCCP
John Davies, RRT, MA, FCCP
Natalie Yip, MD
Craig Rackley, MD, FCCP
Amanda Dexter, RRT, MSc

Airway Management in the Era of Severe COVID Pneumonia

Learning Objectives

  • Participants will develop an understanding of how severe COVID-19 pneumonia with respiratory failure can affect decisions made during management of the airway.
  • Participants will form a plan to APPROACH difficult airway management in COVID-19 patients.
  • Participants will be able to rapidly identify a Failed Airway and techniques to safely and successfully achieve a definitive airway.

Approximately 10% of emergent intubations can result in a failed airway. Management of airways in era of severe pneumonia is further complicated by challenging physiology and need for further protection of the care team from transmission. Rapid recognition and management of the failed airway is essential to patient survival. Management of the failed airway in patients with severe pneumonia includes proper team planning, equipment and technique selection, and crew-resource management. As with any airway in the critically ill, core goals include periprocedural oxygenation and hemodynamic stability.

June Chae. MD
Kevin Doerschug, MD, MS, FCCP
Jonathan Mendelson, MD
Viren Kaul, MD, FCCP

Bronchoscopy-Assisted Percutaneous Tracheostomy Placement and Troubleshooting  – Simulation Demonstration

Learning Objectives

  • Know the relevant head and neck anatomy as it applies to percutaneous tracheostomy procedure.
  • Demonstrate the step-by-step approach to percutaneous tracheostomy procedure.
  • Describe potential percutaneous tracheostomy related complications.
  • Outline measures to prevent and manage complications.

Tracheostomy is one of the common procedures performed by pulmonologists, intensivists, trauma surgeons, otorhinolaryngology, and anesthesia specialists. This session will start with a 20-minute tutorial highlighting the indications, contraindications, and possible short-term and long-term complications related to this procedure. The final 40 minutes will be spent in case-based discussions on tracheostomy troubleshooting on topics such as bleeding, accidental decannulation, and inability to ventilate.

Laura Frye, MD
Sonali Sethi, MD, FCCP
A. Christine Argento, MD
Carla Lamb, MD, FCCP

Integrating Awake Intubation into your Practice

Learning Objectives

  • Identify the situations that are optimal for an awake intubation or when it is contraindicated, and be aware of new published guidelines.
  • Explain the need for topical anesthesia for an awake intubation and which anatomical areas to focus on.
  • Identify the adjuncts used to facilitate an awake intubation, namely an Ovassapian or Williams airway.
  • Demonstrate when to abandon an awake intubation due to refractory or worsening hypoxemia and place an extraglottic airway as a rescue device

This virtual course will demonstrate awake intubation methods in critically ill patients, highlighting important differences from a standard bronchoscopic procedure. Awake Intubation is an important skill to manage patients with potential difficult airways based on airway exam or physiologic parameters. Learn the indications/contraindications, novel methods of preoxygenation/oxygenation during the procedure, and directed/topical airway anesthesia with localization of the appropriate nerves.

John Gaillard, MD, FCCP