This 2 part series was written by Jared Baylis, JoAnne Slinn, and Kevin Clark. Part 1 is a review of the literature around in situ simulation for quality improvement and part 2 will detail the emergency department in situ simulation program at Kelowna General Hospital including successes, lessons learned, and suggestions for those of you … Continue reading In Situ Simulation – Part 1: Quality Improvement Through Simulation
Author: Martin Kuuskne
Simulation Solutions for Low Resource Settings
This review on simulation teaching in a low resource setting was written by Alia Dharamsi, a PGY 4 in Emergency Medicine at The University of Toronto and 2017 SHRED [Simulation, Health Sciences, Resuscitation for the Emergency Department] Fellow after her Toronto- Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) elective. This past November I participated in an … Continue reading Simulation Solutions for Low Resource Settings
Validity – Starting with the Basics
This critique on validity and how it relates to simulation teaching was written by Alia Dharamsi, a PGY 4 in Emergency Medicine at The University of Toronto and 2017 SHRED [Simulation, Health Sciences, Resuscitation for the Emergency Department] Fellow. When designing simulation exercises that will ultimately lead to the assessment and evaluation of a learner’s competency … Continue reading Validity – Starting with the Basics
Simulation-Based Assessment
This critique on simulation-based assessment was written by Alice Gray, a PGY 4 in Emergency Medicine at The University of Toronto and 2017 SHRED [Simulation, Health Sciences, Resuscitation for the Emergency Department] Fellow. You like to run simulations. You have become adept at creating innovative and insightful simulations. You have honed your skills in leading … Continue reading Simulation-Based Assessment
Simulation Design
This critique on simulation design was written by Alice Gray, a PGY 4 in Emergency Medicine at The University of Toronto and 2017 SHRED [Simulation, Health Sciences, Resuscitation for the Emergency Department] Fellow. Have you ever designed a simulation case for learners? If so, did you create your sim on a “cool case” that you … Continue reading Simulation Design
Cashing out by buying in – How expensive does a mannequin have to be to call a simulation “high fidelity?”
This critique on simulation fidelity was written by Alia Dharamsi, a PGY 4 in Emergency Medicine at The University of Toronto and 2017 SHRED [Simulation, Health Sciences, Resuscitation for the Emergency Department] Fellow. How expensive does a mannequin have to be to call a simulation “high fidelity?” That was the question I was pondering this week, … Continue reading Cashing out by buying in – How expensive does a mannequin have to be to call a simulation “high fidelity?”
Aortic Dissection
A 66-year-old female with a history of smoking, HTN and T2DM presents with syncope while walking her dog. She complains of retrosternal chest pain radiating to her jaw. She will become increasingly bradycardic and hypotensive, requiring the team to mobilize resources in order to facilitate diagnosis and management of an aortic dissection.
VSA Megacode
A 54-year-old male police officer presents to the ED complaining of chest pain for two hours that started after his weekend hockey game. He is feeling dizzy and short of breath upon presentation. He will have a VT arrest as he is placed on the monitor. He will require two shocks and rounds of CPR before he has ROSC. He will then loose his pulse again while the team is trying to initiate post-arrest care; this will happen several times. Finally, the team will maintain ROSC. When an ECG is performed, it is revealed that the patient has a STEMI and the team will need to call for emergent PCI.
Tumour Lysis Syndrome
A 72-year-old male is brought in as a “code STEMI” to the resuscitation bay. He was recently diagnosed with ALL and had chemotherapy 3 days ago for the first time. The patient is severely hyperkalemic, which must be initially recognized and treated, hypocalcemic and hyperuricemic as a result of Tumour Lysis Syndrome and the metabolic derangements must be stabilized until emergent hemodialysis is arranged.
Unstable Bradycardia
A 78-year-old male presents to the emergency department with an unstable bradycardia. The patient deteriorates from a second degree, Mobitz Type II-AV block into a third degree AV block requiring ACLS protocol medications, transcutaneous pacing, and ultimately transvenous pacing until definitive management with a permanent pacemaker can be arranged.
EM Sim Cases 