It is organised as follows:

The first page shows the necessary equipment that must be prepared and checked according to the airway management plan, both initial and rescue, for any procedure in which airway management is required (whether scheduled or urgent). Next, the scheme proposed by the airway management working group of Dr. Balmis General University Hospital is presented as a visual cognitive aid for the airway management plan. It also includes a QR code explaining the scheme and the sequences to follow.

The following pages include the checklist for each of the different orotracheal intubation techniques (intubation using direct laryngoscopy; using the Airtraq® videolaryngoscope; and, finally, using the McGrath® videolaryngoscope with both the MAC blade and the hyper‑curved blade). Each technical skill includes a QR code linking to a brief explanatory video of approximately 2–3 minutes.

These checklists have been developed by outlining the key points in a clear and concise manner, in order to ensure easy adherence and compliance. The checklist in PDF format can be used digitally on a mobile phone or printed for availability in the operating room.

It is organised as follows: before the patient enters the operating room, with the patient already in the operating room, and before the patient leaves the operating room.

The first page provides an overview of the workflow structure and timeline in the operating room.

• Before entering the operating room:
  • Patient and Surgery
  • Operating Room Preparation. MSMAID
• In the operating room:
  • Initial general anaesthetic management
  • Emergence and extubation criteria
• After the operating room
  • Safe Transfer
  • Information Handover. SABER

Below are the three tables that outline, in a clear and concise manner, the key points that must be checked and verified at each phase of the surgical process, presented in the form of a checklist to facilitate adherence and proper follow‑up.

The checklist in PDF format can be used digitally on a mobile device or printed for availability in the operating room.

The protocol is structured around role distribution and the critical actions to be followed in the event of laryngospasm in the operating room. It outlines the preparation of equipment, the sequence of interventions, and the administration of emergency medication.

Roles and Responsibilities:

1. Operator:

• • Diagnoses and communicates the presence of laryngospasm.
  • Coordinates the team’s response.

2. TCAE:

• • Prepares the airway equipment.
  • Assists with monitoring and medication administration.

3. Airway Assistant Nurse:

• • Prepares and checks the airway equipment.
  • Monitors and communicates the vital signs.

4. Time and Therapies Nurse:

• • Administers the medication according to medical instructions.
  • Ensures venous access and tracks the timing of interventions.

Critical Sequence:

1. Suspend stimulus.
2. Increase the O2 flow to 100%.
3. Jaw thrust and retroauricular pressure.
4. Apply CPAP/IPPV.
5. Administer Propofol or Succinylcholine as needed.
6. Suction secretions and insert a Guedel airway if needed.

The digital telephone switchboard implemented with Asterisk is structured around a series of critical components: a control system consisting of a Raspberry Pi 4, a configurable router, a VoIP telephone capable of registering SIP accounts, and a tablet acting as an emulator (with the option of replacing it with a VoIP telephone). For its proper operation, the project encompasses several fundamental aspects:

• Architecture Planning: The system structure must be defined in advance, detailing the arrangement of the components, the type of connectivity between them—whether wireless or wired—and the configuration required for the optimal operation of the devices.
• Component Coordination: Synergy among the different elements of the system is essential. Detailed procedures must be followed to ensure that they operate cohesively, as if functioning as a single entity.
• Asterisk Configuration: Proper configuration of Asterisk is essential and represents a significant part of the project. This process includes everything from its installation on the Raspberry Pi to the implementation of the parameters required for optimal performance.
• Automation and Scripting: The use of programming languages such as Python makes it possible to automate essential tasks in Asterisk through scripts, such as adding, deleting, or modifying extensions.
• Maintenance and Scalability: The design must facilitate long‑term maintenance and allow for future expansion of the system. Sustainability is a key component for its viability as a telephone solution in clinical simulations.

The methodological development of the plan is framed within the curricular design proposal of the Simulation Zones from the Center for Medical Simulation.

The central question in methodological planning is: ‘For which situations do personnel (teams and systems) need to be continuously prepared?’

The practical application of this methodology can be found in TEAMWORK: Role Distribution in Immediate Life Support Teams in Hospital Wards.

In this role‑distribution protocol, depending on the number of people forming the team, tasks are prioritized and assigned to the healthcare professionals acting as first responders.

Each responder knows which role they can assume according to their professional competencies and what tasks correspond to that role.

The poster format of the protocol allows for proper display and use in hospital wards, making it a visual cognitive aid to be used during refresher sessions (pre‑process), during resuscitation (in‑process), and as a guide for improvement analysis during clinical debriefing (post‑process).

The checklist covers several key aspects:

• Equipment Compatibility: A meticulous verification of all medical devices accompanying the patient must be carried out to ensure that they are compatible with the magnetic resonance environment and do not pose a risk.
• Team Coordination: Communication between the critical care team and the MRI staff is vital. A clear plan must be established detailing the transfer process, including specific roles and emergency procedures.
• Safety Preparations: It is essential to plan the transfer route, taking into account the need for rapid access to emergency supplies and the possibility of returning the patient to the critical care unit should a critical situation arise.
• Continuous Monitoring: During the transfer, constant surveillance of the patient’s vital parameters must be maintained, using portable monitoring equipment that is safe for the MRI environment.

Welcome to the first edition of ClinicalSim Journal, a publication dedicated to advancing excellence and innovation in the field of clinical simulation. Our mission is to provide healthcare professionals and educators with a valuable resource that reinforces the importance of simulation as a fundamental tool to improve professional safety and the quality of patient care.

Clinical simulation has proven to be a cornerstone in medical education and in the ongoing training of healthcare professionals. Through controlled and realistic environments, it allows professionals to practice skills, make decisions, and manage errors without risk to themselves or to patients. This approach not only enhances clinical competence but also fosters teamwork, effective communication, and critical decision‑making—essential components for patient safety.

In this inaugural issue, we are pleased to introduce the four sections into which the journal will be organized, each designed to address different aspects of clinical simulation:

Innovations in Methodology Section: We explore innovative teaching methodologies that optimize the learning process through clinical simulation. Here, we will share approaches and strategies that challenge conventions and seek to continuously improve the effectiveness of teaching.

Protocols and/or Cognitive Aids: This section is dedicated to the implementation of protocols and cognitive support tools that assist in clinical decision‑making. We will discuss how these aids can be integrated into simulated training to improve the accuracy and efficiency of patient care.

Training Resources: We will present a variety of resources used to train teams and individuals. From high‑fidelity simulators to virtual scenarios, we will explore how each resource can be leveraged to maximize learning and preparedness for real‑world situations.

Technical Solutions: Technology plays a crucial role in clinical simulation. In this section, we will examine innovative technological applications that solve specific problems and contribute to enhancing the learning experience.

Our goal is for ClinicalSim Journal to become a platform for the exchange of knowledge and experiences among those at the forefront of education and clinical practice. We aim to inspire our readers to adopt and adapt these innovations within their own work and study environments, always with the ultimate purpose of improving patient care.

We appreciate your interest and participation in this journey toward excellence in clinical simulation. We hope you find in this journal a source of inspiration, knowledge, and practical tools that you can apply in your daily practice for the benefit of both professional and patient safety.

Welcome to ClinicalSim Journal.

Welcome to the first edition of ClinicalSim Journal, a publication dedicated to advancing excellence and innovation in the field of clinical simulation. Our mission is to provide healthcare professionals and educators with a valuable resource that reinforces the importance of simulation as a fundamental tool to improve professional safety and the quality of patient care.

Clinical simulation has proven to be a cornerstone in medical education and in the ongoing training of healthcare professionals. Through controlled and realistic environments, it allows professionals to practice skills, make decisions, and manage errors without risk to themselves or to patients. This approach not only enhances clinical competence but also fosters teamwork, effective communication, and critical decision‑making—essential components for patient safety.

In this inaugural issue, we are pleased to introduce the four sections into which the journal will be organized, each designed to address different aspects of clinical simulation:

Innovations in Methodology Section: We explore innovative teaching methodologies that optimize the learning process through clinical simulation. Here, we will share approaches and strategies that challenge conventions and seek to continuously improve the effectiveness of teaching.

Protocols and/or Cognitive Aids: This section is dedicated to the implementation of protocols and cognitive support tools that assist in clinical decision‑making. We will discuss how these aids can be integrated into simulated training to improve the accuracy and efficiency of patient care.

Training Resources: We will present a variety of resources used to train teams and individuals. From high‑fidelity simulators to virtual scenarios, we will explore how each resource can be leveraged to maximize learning and preparedness for real‑world situations.

Technical Solutions: Technology plays a crucial role in clinical simulation. In this section, we will examine innovative technological applications that solve specific problems and contribute to enhancing the learning experience.

Our goal is for ClinicalSim Journal to become a platform for the exchange of knowledge and experiences among those at the forefront of education and clinical practice. We aim to inspire our readers to adopt and adapt these innovations within their own work and study environments, always with the ultimate purpose of improving patient care.

We appreciate your interest and participation in this journey toward excellence in clinical simulation. We hope you find in this journal a source of inspiration, knowledge, and practical tools that you can apply in your daily practice for the benefit of both professional and patient safety.

Welcome to ClinicalSim Journal.

The checklist covers several key aspects:

• Equipment Compatibility: A meticulous verification of all medical devices accompanying the patient must be carried out to ensure that they are compatible with the magnetic resonance environment and do not pose a risk.
• Team Coordination: Communication between the critical care team and the MRI staff is vital. A clear plan must be established detailing the transfer process, including specific roles and emergency procedures.
• Safety Preparations: It is essential to plan the transfer route, taking into account the need for rapid access to emergency supplies and the possibility of returning the patient to the critical care unit should a critical situation arise.
• Continuous Monitoring: During the transfer, constant surveillance of the patient’s vital parameters must be maintained, using portable monitoring equipment that is safe for the MRI environment.

In this role‑distribution protocol, depending on the number of people forming the team, tasks are prioritized and assigned to the healthcare professionals acting as first responders.

Each responder knows which role they can assume according to their professional competencies and what tasks correspond to that role.

The poster format of the protocol allows for proper display and use in hospital wards, making it a visual cognitive aid to be used during refresher sessions (pre‑process), during resuscitation (in‑process), and as a guide for improvement analysis during clinical debriefing (post‑process).

The methodological development of the plan is framed within the curricular design proposal of the Simulation Zones from the Center for Medical Simulation.

The central question in methodological planning is: ‘For which situations do personnel (teams and systems) need to be continuously prepared?’

The practical application of this methodology can be found in TEAMWORK: Role Distribution in Immediate Life Support Teams in Hospital Wards.

The digital telephone switchboard implemented with Asterisk is structured around a series of critical components: a control system consisting of a Raspberry Pi 4, a configurable router, a VoIP telephone capable of registering SIP accounts, and a tablet acting as an emulator (with the option of replacing it with a VoIP telephone). For its proper operation, the project encompasses several fundamental aspects:

• Architecture Planning: The system structure must be defined in advance, detailing the arrangement of the components, the type of connectivity between them—whether wireless or wired—and the configuration required for the optimal operation of the devices.
• Component Coordination: Synergy among the different elements of the system is essential. Detailed procedures must be followed to ensure that they operate cohesively, as if functioning as a single entity.
• Asterisk Configuration: Proper configuration of Asterisk is essential and represents a significant part of the project. This process includes everything from its installation on the Raspberry Pi to the implementation of the parameters required for optimal performance.
• Automation and Scripting: The use of programming languages such as Python makes it possible to automate essential tasks in Asterisk through scripts, such as adding, deleting, or modifying extensions.
• Maintenance and Scalability: The design must facilitate long‑term maintenance and allow for future expansion of the system. Sustainability is a key component for its viability as a telephone solution in clinical simulations.

The protocol is structured around role distribution and the critical actions to be followed in the event of laryngospasm in the operating room. It outlines the preparation of equipment, the sequence of interventions, and the administration of emergency medication.

Roles and Responsibilities:

1. Operator:

• • Diagnoses and communicates the presence of laryngospasm.
  • Coordinates the team’s response.

2. TCAE:

• • Prepares the airway equipment.
  • Assists with monitoring and medication administration.

3. Airway Assistant Nurse:

• • Prepares and checks the airway equipment.
  • Monitors and communicates the vital signs.

4. Time and Therapies Nurse:

• • Administers the medication according to medical instructions.
  • Ensures venous access and tracks the timing of interventions.

Critical Sequence:

1. Suspend stimulus.
2. Increase the O2 flow to 100%.
3. Jaw thrust and retroauricular pressure.
4. Apply CPAP/IPPV.
5. Administer Propofol or Succinylcholine as needed.
6. Suction secretions and insert a Guedel airway if needed.

It is organised as follows: before the patient enters the operating room, with the patient already in the operating room, and before the patient leaves the operating room.

The first page provides an overview of the workflow structure and timeline in the operating room.

• Before entering the operating room:
  • Patient and Surgery
  • Operating Room Preparation. MSMAID
• In the operating room:
  • Initial general anaesthetic management
  • Emergence and extubation criteria
• After the operating room
  • Safe Transfer
  • Information Handover. SABER

Below are the three tables that outline, in a clear and concise manner, the key points that must be checked and verified at each phase of the surgical process, presented in the form of a checklist to facilitate adherence and proper follow‑up.

The checklist in PDF format can be used digitally on a mobile device or printed for availability in the operating room.

It is organised as follows:

The first page shows the necessary equipment that must be prepared and checked according to the airway management plan, both initial and rescue, for any procedure in which airway management is required (whether scheduled or urgent). Next, the scheme proposed by the airway management working group of Dr. Balmis General University Hospital is presented as a visual cognitive aid for the airway management plan. It also includes a QR code explaining the scheme and the sequences to follow.

The following pages include the checklist for each of the different orotracheal intubation techniques (intubation using direct laryngoscopy; using the Airtraq® videolaryngoscope; and, finally, using the McGrath® videolaryngoscope with both the MAC blade and the hyper‑curved blade). Each technical skill includes a QR code linking to a brief explanatory video of approximately 2–3 minutes.

These checklists have been developed by outlining the key points in a clear and concise manner, in order to ensure easy adherence and compliance. The checklist in PDF format can be used digitally on a mobile phone or printed for availability in the operating room.