Simulation

Septic Abortion Complicated by Disseminated Intravascular Coagulation

Lauren Moore, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8GH1G Issue 9:2 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) Obtain a relevant focused history including pregnancy history, medication use, and past medical history. 2) Develop a differential for fever and vaginal bleeding in a pregnant patient. 3) Discuss management of septic abortion, including empiric broad-spectrum antibiotics and obstetric consultation for source control with dilation and curettage (D&C). 4) Discuss expected laboratory findings of disseminated intravascular coagulation (DIC). 5) Discuss management of DIC, including identification of underlying etiology and supportive resuscitation with blood products. 6) Review the components of blood products. 7) Identify appropriate disposition of the patient to the intensive care unit (ICU).

Electrical Storm/Refractory Ventricular Tachycardia

Ashley R Tarchione, MD^* and Amrita Vempati, MD^{^}

DOI: https://doi.org/10.21980/J8TS80 Issue 9:2 No ratings yet.

By the end of this simulation, learners should be able to: 1) recognize unstable ventricular tachycardia and initiate ACLS protocol, 2) practice dynamic decision making by switching between various ACLS algorithms, 3) create a thoughtful approach for further management of refractory ventricular tachycardia, 4) interpret electrocardiogram (ECG) with ST-segment elevation (STE) and left bundle branch block (LBBB), 5) appropriately disposition the patient and provide care after return of spontaneous circulation (ROSC), 6) navigate a difficult conversation with the patient’s husband when she reveals that the patient’s wishes were to not be resuscitated.

Cardiology/Vascular Simulation

Managing STEMIs without a Catheterization Lab: A Simulated Scenario to Improve Emergency Clinician Recognition and Execution of Thrombolysis in the Setting of Rural STEMI Management

Scott Schoenborn, MD,^{*^} Anthony F Steratore, MD,^{*^} Adam Hoffman, CHSE,^{*^} Thomas C Marshall, MD,^{*^} Erica B Shaver, MD,^{*^} and Christopher S Kiefer, MD^{*^}

DOI: https://doi.org/10.21980/J8K933 Issue 9:2 No ratings yet.

By the end of this simulation, learners will be able to: 1) diagnose ST elevation myocardial infarction accurately and initiate thrombolysis in the rural setting without timely access to cardiac catheterization; 2) engage the simulated patient in a shared decision-making conversation, clearly outlying the benefits and risks of thrombolysis; 3) identify the indications and contraindications for thrombolysis in ST elevation myocardial infarction; 4) arrange for transfer to a tertiary care center following completion of thrombolysis.

Cardiology/Vascular Simulation

An Appy That Needs Epi: An Atypical Presentation of Anaphylaxis

Ryan O’Neill, MD^*, Cyrus Adeli, BA, CHSE^{^}, and Christopher E San Miguel, MD, MEd^*

DOI: https://doi.org/10.21980/J80H14 Issue 9:1 No ratings yet.

At the conclusion of the simulation, learners will be able to: 1) demonstrate ability to efficiently review patient records to optimize patient care and identify relevant details to current presentation, 2) rapidly assess a patient when there is a change in clinical status, 3) recognize the need to start resuscitative fluids for undifferentiated hypotension, 4) identify anaphylaxis, 5) demonstrate the medical management of anaphylaxis, 6) utilize the I-PASS framework to communicate with the inpatient team during the transition of care.

Abdominal/Gastroenterology Dermatology Simulation

Adolescent with Diabetic Ketoacidosis, Hypothermia and Pneumomediastinum

Steven Millner, MD^* and Courtney Devlin, MD^*

DOI: https://doi.org/10.21980/J8FP8J Issue 8:4 No ratings yet.

By the end of the simulation, learners will be able to: 1) develop a differential diagnosis for an adolescent who presents obtunded with shortness of breath; 2) discuss the management of diabetic ketoacidosis; 3) discuss management of hypothermia in a pediatric patient; 4) discuss appropriate ventilator settings in a patient with diabetic ketoacidosis; and 5) demonstrate interpersonal communication with family, nursing, and consultants during high stress situations.

Endocrine Pediatrics Procedures Respiratory Simulation

Ventricular Tachycardia

Rohit Menon, MD^*, Geremiha Emerson, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8KD2R Issue 8:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) identify the different etiologies of VT, including structural heart disease, acute ischemia, and acquired or congenital QT syndrome; 2) describe confounding factors of VT, such as electrolyte abnormalities and sympathetic surge; 3) describe how to troubleshoot an unsuccessful synchronized cardioversion, including checking equipment connections, increasing delivered energy, and changing pad placement; 4) compare and contrast treatments of VT based on suspected underlying etiology; 5) describe reasons to activate the cardiac catheterization lab other than occlusive myocardial infarction; and 6) identify appropriate disposition of the patient to the cardiac catheterization lab.

Cardiology/Vascular Simulation

Inhalational Injury Secondary to House Fire

Ryan O’Neill, MD^*, Benjamin M Ostro, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8TW7N Issue 8:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) recognize the indications for intubation in a thermal burn/inhalation injury patient; 2) develop a systematic approach to an inhalational injury airway; and 3) recognize indications for transfer to burn center.

Respiratory Procedures Simulation

Alcohol Withdrawal with Delirium Tremens

Courtney Schwebach, MD^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8S35N Issue 8:3 No ratings yet.

By the end of the session, learner will be able to 1) discuss the causes of altered mental status, 2) utilize CIWA scoring system to quantify AW severity, 3) formulate appropriate treatment plan for AW by treating with benzodiazepine and escalating treatment appropriately, 4) treat electrolyte abnormalities by giving appropriate medications for hypokalemia and hypomagnesemia, and 5) discuss clinical progression and timing to AW.

Simulation Toxicology

Headache Over Heels: CT Negative Subarachnoid Hemorrhage

Sarah Hogan, MD^*, Sara Dimeo, MD, MEHP^{^} and Caroline Astemborski, MD, MEHP^*

DOI: https://doi.org/10.21980/J8ND2C Issue 8:3 No ratings yet.

By the end of this case, the participant will be able to: 1) construct a broad differential diagnosis for a patient presenting with syncope, 2) name the history and physical exam findings consistent with SAH, 3) identify SAH on computer tomography (CT) imaging, 4) identify the need for lumbar puncture (LP) to diagnose SAH when CT head is non-diagnostic > 6 hours after symptom onset, 5) correctly interpret cerebral fluid studies (CSF) to aid in the diagnosis of SAH, and 6) specify blood pressure goals in SAH and suggest appropriate medication management.

Neurology Simulation

Peripartum Cardiomyopathy

Victoria L Morris, MD^*, Carolina Mendoza, MD^*, Gowri S Stevens, MD^*, Jessica L Wilson, MD^*and Adeola A Kosoko, MD^*

DOI: https://doi.org/10.21980/J8ZS9M Issue 8:2 No ratings yet.

By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy.

Cardiology/Vascular Ob/Gyn Simulation