This simulation-based educational activity is designed to introduce anesthesia trainees to the critical actions and clinical reasoning required for the safe initiation and discontinuation of cardiopulmonary bypass (CPB) during cardiac surgery. The case presents an adult patient undergoing aortic valve replacement requiring CPB support. Learners are expected to demonstrate foundational knowledge of anticoagulation management, key procedural steps for going onto and coming off bypass, and perioperative considerations such as glucose control, urine output monitoring, and hemodynamic support. Conducted in a high-fidelity simulation environment, the activity provides a low-risk experiential learning opportunity that prepares junior trainees for their first clinical exposure to cardiac anesthesia and CPB management.
Target Learners
- Anesthesiology residents (primarily CA-1 and CA-2 trainees)
- Junior anesthesia trainees preparing to begin a cardiac anesthesia rotation
- Advanced residents (e.g., CA-3) may participate for skills reinforcement or act as facilitators
Learners are expected to have completed several months of general clinical anesthesia training prior to participation.
Equipment Needed
Recommended simulation environment includes:
Simulation Platform
- High-fidelity human patient simulator (e.g., adult SimMan or equivalent)
Monitoring Equipment
- Noninvasive blood pressure cuff
- Arterial line monitoring
- Pulse oximeter
- Capnography
- Electrocardiogram (EKG)
- Temperature probe
- Real-time vital signs display system
Airway and Procedural Supplies
- Laryngoscope
- Supraglottic airway devices
- Adult and pediatric endotracheal tubes
- Operating room–style anesthesia machine
Medications (Simulated)
Pre-prepared syringes representing:
- Propofol
- Etomidate
- Succinylcholine
- Rocuronium
- Fentanyl
- Lidocaine
- Ketamine
- Midazolam
- Ephedrine
- Phenylephrine
Additional (Optional)
- Cardiopulmonary bypass circuit
- Pediatric manikin (for resuscitation phase)
- Simulation technician support
- Perfusionist (beneficial but not required)
Estimated Time to Complete Activity
- Simulation Session: ~1 hour
- Post-simulation Debriefing: Typically conducted immediately afterward (variable duration)
This activity is often paired with an additional 1-hour didactic session on CPB circuitry within the broader curriculum.