II. Definitions

  1. High Acuity Low Opportunity Procedure (HALO Procedure, HALO Event)
    1. Risky, rare procedures (e.g. Cricothyrotomy) in life threatening events

III. Approach

  1. Maintaining procedural competence and proficiency
    1. We lose skills over time in procedures we perform infrequently
    2. Skills start waning as early as 2 months after the last time performed
    3. Practice procedural skills frequently (e.g. visualization, procedure courses)
    4. Schedule procedure self-study and practice frequently (e.g. one procedure per month for 30 minutes)
    5. Watch online procedure videos
    6. Improvise practice tools (e.g. toilet paper roll for Cricothyrotomy practice)
    7. Coordinate group procedure practice
  2. Use visualization to learn or prepare for a procedure
    1. Picture the scenario, the environment and the patient
    2. Visualize the step-by-step approach to performing the procedure
    3. Move your hands as if performing the procedure, and vocalize orders
    4. Orman, Herbert and Cloyd in Herbert (2017) EM:Rap 17(4):14

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