Osler's Emergency Room team pushes the boundaries of what is possible, tapping into simulation training and teamwork to save a life.

Osler’s simulation program a life-saver for patient

It’s a case he’d never seen before, but which he had spent years preparing for. Emergency Physician Dr. Luke Hays had just started his night shift in the Emergency Department at Brampton Civic Hospital when a patient was rushed in with a life-threatening injury to the heart.

The clock was ticking. Within seconds, Dr. Hays knew what would need to be done to save the patient’s life. Within minutes, he had gathered his equipment, mobilized a group of physicians, nurses and respiratory therapists and prepared to perform a resuscitative thoracotomy – a rare procedure which involves ‘cracking open the chest’ – should the patient’s condition worsen.

It did and the team, which included Dr. Jerome Fan, Dr Michal Piotrowski, Dr. Martin Kuuskne and Dr. Vineet Nikore, took action, identifying and repairing the patient’s injuries, all without leaving the ED. From there, the patient was transported to the Operating Room and the Thoracic Surgery and Intensive Care Unit teams, led by Dr. Ching Yeung and Dr. Brooks Fallis, took over.

Despite catastrophic trauma to the heart and low survival rates for thoracotomy in the ED, the patient survived. Dr. Hays credits Osler’s In Situ Simulation Program, Point of Care Ultrasound (POCUS) training and his 'incredible team' for giving this patient a second chance at life. He says that the successful outcome "came down to the way we mobilized our team and resources, identified roles, and made decisions early."

Osler’s In Situ Simulation Program is a physician-led initiative started by Dr. Hanzla Tariq and Dr. Vaquas Shaikh in February of 2016. The goal of the program is to give medical teams an opportunity to practice complex and challenging resuscitations on simulated patients in order to improve and optimize diagnosis and treatment, communication, teamwork and crisis resource management.

Dr. Hays also says that the use of POCUS was critical to the patient’s successful outcome. "Thanks to bedside ultrasound skills gained through the Osler POCUS Program lead by Dr. Jeff Handler and Dr. Prashant Phalpher, we were able to identify that the patient’s injury was to the heart, and that the lungs and abdomen were not traumatized."

"Emergency Medicine is filled with rare procedures and clinical situations that you may never see but you always have be prepared for,” said Dr. Hays. “This case is a perfect example."

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