Management of Pre-eclampsia and Eclampsia: A Simulation

Introduction Pre-eclampsia is a hypertensive disorder in pregnancy. Maternal sequelae that may occur include impaired liver function, disseminated intravascular coagulation, seizures (eclampsia), stroke, and death. Thus, providers should know how to recognize (diagnose) and treat pre-eclampsia and e...

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Autores principales:	Cynthia Abraham, Natalya Kusheleva
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2019
Materias:	Pre-eclampsia Eclampsia Emergent Hypertension Pregnancy Simulation Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/e7c932bdd6534784b6bb2b8c439039a2
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spelling	oai:doaj.org-article:e7c932bdd6534784b6bb2b8c439039a22021-11-22T13:57:26ZManagement of Pre-eclampsia and Eclampsia: A Simulation10.15766/mep_2374-8265.108322374-8265https://doaj.org/article/e7c932bdd6534784b6bb2b8c439039a22019-08-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10832https://doaj.org/toc/2374-8265Introduction Pre-eclampsia is a hypertensive disorder in pregnancy. Maternal sequelae that may occur include impaired liver function, disseminated intravascular coagulation, seizures (eclampsia), stroke, and death. Thus, providers should know how to recognize (diagnose) and treat pre-eclampsia and eclampsia. Methods A simulator with noninvasive blood pressure monitoring was used. Transducers for fetal heart rate and contraction monitoring were placed on the simulator, which represented the patient. After obtaining a history and performing a physical examination, resident physician (postgraduate years 1–4) and nurse learners had to diagnose pre-eclampsia and treat this condition. They also had to treat severe-range blood pressures and manage eclampsia. Learner performance was assessed with a checklist. Debriefing followed the simulation. Results Thirty resident learners participated in the study. Nurses did not participate. All resident learners indicated familiarity with the diagnosis and management of pre-eclampsia and emergent hypertension and managed these conditions correctly. All resident learners reported not being confident in managing eclampsia. None of the learners were able to stop the eclamptic seizure. All resident learners were more confident in managing eclampsia after the scenario compared with before (mean confidence level 3.6 ± 0.5 vs. 1.1 ± 0.4, p < .001). Discussion Resident learners were familiar with the management of pre-eclampsia and emergent hypertension but not with eclampsia. We recommend that eclampsia simulations occur in a laboratory and in situ on the labor and delivery floor with interprofessional team members including obstetricians, nurses, anesthesiologists, emergency and family medicine physicians, nurse practitioners, and physician assistants.Cynthia AbrahamNatalya KushelevaAssociation of American Medical CollegesarticlePre-eclampsiaEclampsiaEmergent HypertensionPregnancySimulationMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 15 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pre-eclampsia Eclampsia Emergent Hypertension Pregnancy Simulation Medicine (General) R5-920 Education L
spellingShingle	Pre-eclampsia Eclampsia Emergent Hypertension Pregnancy Simulation Medicine (General) R5-920 Education L Cynthia Abraham Natalya Kusheleva Management of Pre-eclampsia and Eclampsia: A Simulation
description	Introduction Pre-eclampsia is a hypertensive disorder in pregnancy. Maternal sequelae that may occur include impaired liver function, disseminated intravascular coagulation, seizures (eclampsia), stroke, and death. Thus, providers should know how to recognize (diagnose) and treat pre-eclampsia and eclampsia. Methods A simulator with noninvasive blood pressure monitoring was used. Transducers for fetal heart rate and contraction monitoring were placed on the simulator, which represented the patient. After obtaining a history and performing a physical examination, resident physician (postgraduate years 1–4) and nurse learners had to diagnose pre-eclampsia and treat this condition. They also had to treat severe-range blood pressures and manage eclampsia. Learner performance was assessed with a checklist. Debriefing followed the simulation. Results Thirty resident learners participated in the study. Nurses did not participate. All resident learners indicated familiarity with the diagnosis and management of pre-eclampsia and emergent hypertension and managed these conditions correctly. All resident learners reported not being confident in managing eclampsia. None of the learners were able to stop the eclamptic seizure. All resident learners were more confident in managing eclampsia after the scenario compared with before (mean confidence level 3.6 ± 0.5 vs. 1.1 ± 0.4, p < .001). Discussion Resident learners were familiar with the management of pre-eclampsia and emergent hypertension but not with eclampsia. We recommend that eclampsia simulations occur in a laboratory and in situ on the labor and delivery floor with interprofessional team members including obstetricians, nurses, anesthesiologists, emergency and family medicine physicians, nurse practitioners, and physician assistants.
format	article
author	Cynthia Abraham Natalya Kusheleva
author_facet	Cynthia Abraham Natalya Kusheleva
author_sort	Cynthia Abraham
title	Management of Pre-eclampsia and Eclampsia: A Simulation
title_short	Management of Pre-eclampsia and Eclampsia: A Simulation
title_full	Management of Pre-eclampsia and Eclampsia: A Simulation
title_fullStr	Management of Pre-eclampsia and Eclampsia: A Simulation
title_full_unstemmed	Management of Pre-eclampsia and Eclampsia: A Simulation
title_sort	management of pre-eclampsia and eclampsia: a simulation
publisher	Association of American Medical Colleges
publishDate	2019
url	https://doaj.org/article/e7c932bdd6534784b6bb2b8c439039a2
work_keys_str_mv	AT cynthiaabraham managementofpreeclampsiaandeclampsiaasimulation AT natalyakusheleva managementofpreeclampsiaandeclampsiaasimulation
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Management of Pre-eclampsia and Eclampsia: A Simulation

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