Anesthesia Patient Safety Podcast
The official podcast of the Anesthesia Patient Safety Foundation (APSF) is hosted by Alli Bechtel, MD, featuring the latest information and news in perioperative and anesthesia patient safety. The APSF podcast is intended for anesthesiologists, anesthetists, clinicians and other professionals with an interest in anesthesiology, and patient safety advocates around the world.
The Anesthesia Patient Safety Podcast delivers the best of the APSF Newsletter and website directly to you, so you can listen on the go! This includes some of the most important COVID-19 information on airway management, ventilators, personal protective equipment (PPE), drug information, and elective surgery recommendations.
Don't forget to check out APSF.org for the show notes that accompany each episode, and email us at podcast@APSF.org with your suggestions for future episodes. Visit us at APSF.org/podcast and at @APSForg on Twitter, Facebook, and Instagram.
Anesthesia Patient Safety Podcast
#239 Enhancing Defibrillation Skills: The APSF's Technology Education Initiative
Unlock the potential to save lives with our exciting discussion on the Anesthesia Patient Safety Foundation's Technology Education Initiative course. Featuring Dr. Michael Kazior, an esteemed anesthesiologist and intensivist, we spotlight the crucial skills of manual external defibrillation, cardioversion, and pacing. Dr. Kazior shares his personal journey and highlights the stark educational gaps in defibrillator usage among anesthesia professionals. This course, born from the collaboration between the APSF and the American Society of Anesthesiologists, promises an interactive learning experience that aims to bolster confidence and competence in using these vital life-saving devices. Additionally, this course is a robust addition to the APSF's suite of courses, including those on low-flow anesthesia and quantitative neuromuscular monitoring, all designed to equip anesthesia professionals with comprehensive knowledge of essential technologies.
For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/239-enhancing-defibrillation-skills-the-apsfs-technology-education-initiative/
© 2025, The Anesthesia Patient Safety Foundation
You're listening to the Anesthesia Patient Safety Podcast, the official podcast of the Anesthesia Patient Safety Foundation. We're bringing you the very best from the APSF newsletter and website, as well as the latest information in perioperative patient safety. Thanks for joining us, hello.
Speaker 2:Hello and welcome back to the Anesthesia Patient Safety Podcast. My name is Allie Bechtel and I'm your host. Thank you for joining us for another show. We have some good news to share. The APSF has developed another technology education initiative course. That's right. This will be the third course offered by the APSF. It is electrifying and we are going to be talking about it today. Before we dive further into the episode, we'd like to recognize Solventum, a major corporate supporter of APSF. Solventum has generously provided unrestricted support to further our vision that no one shall be harmed by anesthesia care. Thank you, solventum. We wouldn't be able to do all that we do without you.
Speaker 2:We are returning to the October 2024 newsletter. That's right. There is still more to talk about. Our featured article is APSF Announces development of third technology education initiative course manual external defibrillation, cardioversion and pacing by Michael Kayser and colleagues. To follow along with us, head over to APSForg and click on the newsletter heading. The first one down is the current issue. From here, scroll down until you get to our featured article today. I will include a link in the show notes as well To help kick off the show. Today we are going to hear from the author. Let's take a listen now.
Speaker 3:Hi, my name is Michael Kayser and I am an anesthesiologist and intensivist at Virginia Commonwealth University Health and the Richmond Veterans Affairs Medical Center in Richmond, Virginia.
Speaker 2:I asked Kajur what got him interested in this topic. Here is his response.
Speaker 3:When I was an anesthesia resident. I don't remember ever actually using an external manual defibrillator myself. Remember ever actually using an external manual defibrillator myself. Then, when I started my critical care fellowship, on one of my first days I had to perform a cardioversion on a patient in AFib with RVR and had to sheepishly admit to my attending that I wasn't sure how to do it. As an attending physician, leading simulation didactics, it became clear to me that most providers shared this same hesitation to use the defibrillator that I once did. I feel the main problem is that there are not a lot of great educational resources out there for this device. The American Heart Association has transitioned away from in-person teaching and the manufacturers primarily only have passive video tutorials available on their websites. It is not a difficult device to operate. We just need a means to learn and refresh our skills, since most providers don't use this defibrillator very frequently.
Speaker 2:Thank you so much to Kajer for helping to introduce this topic, and now it's time to get into the article. The authors start with a case, so let's head into the operating room. You are taking care of a 64-year-old man undergoing an above-the-knee amputation under general anesthesia. Does this sound familiar to anyone? Anesthesia Does this sound familiar to anyone? Despite a stable intraoperative course, his heart rhythm suddenly changes to atrial fibrillation, with a rapid ventricular response in the 170s. With the change in rhythm, his systolic blood pressure is in the 60s and oxygen saturation is decreasing. You call for help, notify the team and the operating room nurse brings in the crash cart with the manual external defibrillator. You know that a cardioversion is indicated and time is of the essence to prevent further decompensation. Do you know where to place the pads? Which setting do you select for mode and at what energy? How will you know you are synchronized for the cardioversion to prevent an R on T phenomenon? Your heart rate is probably rising at this moment too. These are all very good questions that we need to have the answers for before we step foot in the operating room, and this course will help.
Speaker 2:Thankfully, perioperative cardiac arrest is a rare event. When it does occur, anesthesia professionals need to be ready to make the diagnosis and provide life-saving treatment, which may involve the prompt and correct use of a manual external defibrillator. The prompt and correct use of a manual external defibrillator. This device is used for in-hospital ACLS clinicians to perform an indicated defibrillation, synchronized cardioversion and or transcutaneous pacing. When was the last time you had to use a manual external defibrillator? Keep in mind that this is a rarely used device. Combined with the high stress setting of a life-threatening cardiac event, which then may lead to human error, including device mismanagement or delayed delivery of therapy and, ultimately, failure to rescue. Failure to rescue. Advanced cardiovascular life support, or ACLS.
Speaker 2:Certification and training is often completed with online e-learning programs provided by the American Heart Association. Once certified, acls, providers are required to complete short refresher sessions every three months instead of the every two-year time frame that was used in the past. Unfortunately, many of these online courses do not include education on the use of defibrillators. This may lead to a significant knowledge gap over time. There is a call to action for easily accessible learning opportunities to teach clinicians how to use this device and to maintain the knowledge over time so that they are prepared to act quickly and competently with the defibrillator when needed during a crisis.
Speaker 2:Here's the good news the APSF, in collaboration with the American Society of Anesthesiologists, has developed the third Technology Education Initiative course. It is Manual External Defibrillation, cardioversion and Pacing. This will be in addition to the first two courses, which covered low-flow anesthesia and quantitative neuromuscular monitoring. This is a great way to increase your knowledge base on these complex and technology-based concepts, with guided interactive simulations. It is an active learning experience that you do not want to miss. Let's go through the defibrillation course now. It includes seven different topics to cover the essentials of understanding and using a manual external defibrillator, and each will take about 15 minutes to complete. We recommend completing the topics in order, but you don't have to complete them all at once. Here are some of the highlights of the course Physics of Defibrillators a brief explanation of the physics behind the device that will allow you to better understand the manual external defibrillator.
Speaker 2:Defibrillator waveforms. Visualize and practice delivering the different types of electricity waveforms emitted from commonly used defibrillators Defibrillator pad or electrode placement. Practice placing defibrillator pads on a simulated patient in the different anatomical locations, including anterior-posterior and anterior-lateral Defibrillation, synchronized cardioversion and transcutaneous pacing. Use a simulated generic manual external defibrillator to practice performing the three main functions of the device. Check out figure one in the article to see what the simulated device looks like, and I will include it in the show notes as well.
Speaker 2:This course is projected to go live this month, so mark your calendars. Oh, I forgot to mention the best part. The course is free and readily accessible. You can find it at the ASA website through the APSF web portal, and I will include a link in the show notes as well. Anyone who is interested in taking this course or any of the free Technology Education Initiative courses can do so by creating a free guest account if you are not already an ASA member.
Speaker 2:Did I mention that there are continuing medical education credits available to those who complete the course, including patient safety and quality improvement. So what are you waiting for? Head over to APSForg and click on the patient safety resources heading. The ninth one down is APSF Technology Education Initiative, and you can find all three courses here and a link to the portal. We hope that this course helps to better prepare you to manage a perioperative ACLS event as you work to keep patients safe during anesthesia care. Before we wrap up for today, we are going to hear from Kajur again. I also asked him what is next for his research and projects. Let's take a listen to what he had to say.
Speaker 3:The TEI that we are launching this winter is a generic course meant to teach providers the basic concepts behind the manual external defibrillator. We wanted to be device agnostic, so we created a generic faceplate for users to practice on. The next step we want to take is to create manufacturer-specific versions of the simulation so that, once users finish the generic course, they can practice on the device that they would actually use in the clinical environment. Each device is different in terms of layout, knobs and buttons, so we feel it would be beneficial to provide our learners this opportunity. This way, providers will be even more confident in their ability to use a defibrillator if they find themselves in a crisis.
Speaker 2:Thank you so much to Kajer for helping to develop this course and contributing to the show today. We are looking forward to checking out the manufacturer-specific versions for this defibrillation simulation in the future. If you have any questions or comments from today's show, please email us at podcast at apsforg. Please keep in mind that the information in this show is provided for informational purposes only and does not constitute medical or legal advice purposes only and does not constitute medical or legal advice. We hope that you will visit apsforg for detailed information and check out the show notes for links to all the topics we discussed today.
Speaker 2:The APSF newsletter is the official journal of the Anesthesia Patient Safety Foundation. Readers include anesthesia professionals, perioperative providers, key industry representatives and risk managers. It is free of charge and available in a digital format with a focus on anesthesia-related perioperative patient safety issues. It is almost time for the release of the February newsletter and the deadline for the June 2025 APSF newsletter is right around the corner, on March 1st. Check out the guide for authors over at APSForg for more information and I will include a link in the show notes as well. Who knows, you could be the next APSF newsletter author and we might be featuring your article on a future anesthesia patient safety podcast. So what are you waiting for? Go ahead and submit your article today. Until next time, stay vigilant so that no one shall be harmed by anesthesia care.