The Sim Life
Simulation is great for learning how to do procedures. But to date, its been my experience, that simulation doesn’t approximate life very at all. I think that of my 5 or so central lines at this point, on approximately zero of the patients was I able to identify anatomical landmarks to the the patients due to excessive “girth”. The last guy, was damn near impossible. While on ultrasound he had a nice juicy internal jugular, trying to keep excessive neck rolls out of the way so you can place your needle, much less keep it in view on the ultrasound was damn near impossible with only two hands. Not to mention establishing and protecting a sterile field when one person has to be under the sterile field retracting folds of skin. And does the adhesion on the clear plastic of the field actually make a seal to keep the area sterile? Of course not. By the end of the procedure, are you literally dripping sweat onto your field. Is anyone surprise by the fact that this guy got a line infection? Not me. Checklists don’t seem to cover these type of issues.