Computers in radiology - The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents

Background. Awareness and preparedness to handle sedation, analgesia, and c ontrast-media complications are key in the daily radiology practice. Objective. The purpose is to create a computerized simulator (PC-Windows-ba sed) that uses a graphical interface to reproduce critical incidents in ped iatric and adult patients undergoing a wide spectrum of radiologic sedation , analgesia and contrast media complications. Materials and methods. The computerized simulator has a comprehensive set o f physiologic and pharmacologic models that predict patient response to man agement of sedation, analgesia, and contrast-media complications. Photoreal istic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis. Results. Thirteen pediatric and adult radiology scenarios are illustrated e ncompassing areas such as pediatric radiology, neuroradiology, intervention al radiology, and body imaging. The multiple case scenarios evaluate random ly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstructio n, apnea, agitation, bronchospasm, hypotension,hypertension,cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control t he airway breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the pro gram to suggest diagnostic and treatment steps to save the patient, and pro vide information about the medications. A printout of the case management c an be obtained for evaluation or educational purposes. Conclusion. The interactive computerized simulator is a new approach to tra in and evaluate radiologists' responses to critical incidents encountered d uring radiologic sedation, analgesia, and contrast-media administration.