Development of a sympathetic response to laryngoscopy and endotracheal tube placement in a patient simulator.

Anesthesiologists have long recognized that there is a sympathetic response to stimulation of the larynx, even in sedated patients. This response creates a rapid increase in blood pressure and heart rate in these patients. For the last 40 years, various simulation systems have been used to train anesthesiologists in the skills to be successful practitioners, simulating various disease states and crisis conditions. However, these systems do not contain this well-recognized sympathetic response to laryngoscopy and intubation. Using several experienced anesthesiologists as subject matter experts, we have developed a scenario that mimics this response for several types of patients. This scenario runs on the Medical Education Technologies, Inc. (METI) patient simulators; however, the methodology used to develop this scenario applies to other patient simulator systems.