The Simulation Centre in Anaesthesia and Intensive Care in Bucharest (CESIMAB) is one of the five simulation centres in Romania established and equipped in 2019, collaborating between Romanian authorities and the Swiss Government. Its activity has been steadily improving through in-house training, participation in international projects such as C-19 Space, and courses provided at the national congresses of the Romanian Society of Anaesthesia and Intensive Care.

In 2021, CESIMAB presented a complex simulation scenario aiming to teach the management of a multiple trauma patient hospitalized in the intensive care unit (ICU).

The students, ICU resident doctors from the Bucharest Emergency Clinical Hospital and the Emergency Institute for Cardiovascular Diseases “Prof. C. C. Iliescu”, experienced a clinical scenario warranting patient evaluation, clinical decision making, therapy and multidisciplinary team management. During debriefing, CESIMAB trainers and trainees discussed aspects related to case management, including the importance of adequate ABCDE and SBAR assessment, hierarchization of critical care support and leadership.

The simulation experience was filmed and edited into a 15-minute movie, soon to be available online at the 2021 Congress of the Romanian Society of Anaesthesia and Intensive Care and discussed with field experts in intensive care medicine, education, and simulation, integrating real-time feedback from the audience.

The CESIMAB team from Emergency Institute for Cardiovascular Diseases “Prof. C. C. Iliescu” is also heavily involved in the SAFETY project. Our recent endeavour sets out the stage for future online case-based simulations conceived to provide immersive and didactic training experience in medical conditions specific to emergency and critical care medicine. Additionally, awaiting further refinement and input from our project members, this case may be a mere trailer of SAFETY results.

Figure 1 – Working on the scenario – CESIMAB Team in action (ABCDE and SBAR assessment)
Figure 2 – Working on the scenario – CESIMAB Team in action (intubating a difficult airway (i.e., spine stabilization for neck injury) that poses significant physiological challenges due to new-onset hemodynamic instability)
Figure 3 – Working on the scenario – CESIMAB Team in action (POCUS unveils the root cause of patient deterioration, i.e., pericardial tamponade after polytrauma with chest, abdominal and neck injuries)
Figure 4 – – Working on the scenario – CESIMAB team coordinator

Authors: Liana Văleanu, Mihai Ștefan, Cosmin Bălan, Cornel Robu, Cornelia Florescu, Șerban Bubenek, Daniela Filipescu

Case conceptualization: Cosmin Bălan, Liana Văleanu, Mihai Ștefan, Cristian Cobilinschi, Oana Melente

Acknowledgements:

  • CESIMAB members: Cristian Cobilinschi, Oana Maria Melente, Bianca Moroșanu
  • CESIMAB trainees: Bianca Pancu, Luca Madek, Andrei Dumitrache, Antonia Coman, Adela Grasu, Adina Rusu