Severe Sepsis Manifesting as A-Fib with Rapid Ventricular Rate
Correspondence should be addressed to Jennifer Yee, DO at jennifer.yee@osumc.edu
DOI: https://doi.org/10.21980/J8WG9W
ABSTRACT:
Audience:
This simulation is designed to educate emergency medicine residents and medical students on the diagnosis and management of an adult patient with sepsis due to a decubitus ulcer manifesting as acute-onset atrial fibrillation (A-fib) with rapid ventricular response (RVR).
Introduction:
Adult patients frequently present critically ill from sepsis. Proper diagnosis and management require a focused but thorough history and physical exam, as well as an appropriate diagnostic workup. Management includes aggressive care with antibiotics and intravenous fluids, and may require vasoactive agents.
Objectives:
By the end of this simulation session, the learner will be able to: 1) Recognize severe sepsis (please note – Centers for Medicare and Medicaid Services (CMS) Sepsis-I and II definitions are used throughout the case, as Sepsis-III has not been adopted by any emergency medicine organizations), 2) recognize atrial fibrillation, 3) review the importance of a thorough history and physical exam, 4) discuss the sepsis spectrum, 5) discuss the acute management of severe sepsis, 6) discuss common and uncommon sources of sepsis, 7) discuss appropriate empiric antibiotic options, 8) discuss common causes of newly-diagnosed atrial fibrillation, 9) review the different emergency medicine-based treatment modalities for uncomplicated atrial fibrillation, specifically atrial fibrillation with rapid ventricular rate.
Method:
This session was conducted using high-fidelity simulation, followed by a debriefing session.
Topics:
Severe sepsis, atrial fibrillation, atrial fibrillation with rapid ventricular response, medical simulation.
