A 60-year-old male presents with a four-day history of abdominal pain secondary to cholangitis. The patient presents in septic shock requiring intravenous fluid resuscitation, empiric broad-spectrum antibiotics and vasopressor support and suffers a PEA arrest prior to disposition to advanced imaging or definitive management.
A 70-year-old male presents to the emergency department after a syncopal episode and then found to be obtunded by his daughter. He is hypotensive and tachycardic on arrival secondary to a AAA rupture into the retroperitoneal space. He requires intubation and fluid resuscitation with blood products to avoid a PEA arrest secondary to hypovolemia.
A 34-year-old male was found unconscious in an alleyway by bystanders who called EMS. The patient presents with a clinical opioid intoxication requiring naloxone administration. The patient also presents with acute respiratory distress syndrome (ARDS) secondary to heroin use requiring airway support, intubation and mechanical ventilation.
In part 1 of this two part series (https://emsimcases.com/2015/04/21/how-to-develop-targeted-simulation-learning-objectives-part-1-the-theory/), we used the revised Bloom’s taxonomy to describe an approach to developing simulation-based learning objectives by targeting a specific, complex knowledge domain and a higher level cognitive process. Now that we know the theory behind making targeted simulation learning objectives, what kind of learning objectives should … Continue reading How to develop targeted simulation learning objectives – Part 2: The Practice
In order for a simulated scenario to run smoothly, the case progression needs to be planned for in advance. This involves determining which states the patient simulator progresses through, how modifiers may change features of those states and what triggers will be used to change between states. A working understanding of these terms makes developing … Continue reading Case progression: states, modifiers and triggers
A 27-year-old male presents to the emergency department with altered mental status after an intentional Amitriptyline overdose. He is found to have a wide QRS complex and an anticholinergic toxidrome. The patient deteriorates into PEA arrest necessitating advanced cardiac life support (ACLS) and intravenous sodium bicarbonate therapy.
Simulation has filled a void that was once present in medical education. Written and oral examinations continue to be used to assess Miller’s “knows” and “knows how” levels of performance while clinical rotation evaluations rest at the top of the triangle: “Does”. Simulation completes Miller’s triangle by allowing learners to “show how” their knowledge and … Continue reading How to develop targeted simulation learning objectives – Part 1: The Theory
A 26-year-old man who suffered a syncopal event while playing soccer presents to the emergency department with a stable wide-complex tachycardia (WCT). The patient must be treated with an antiarrhythmic medication or by synchronized cardioversion. The patient later deteriorates into an unstable WCT and then ventricular fibrillation requiring advanced cardiac life support (ACLS) and defibrillation.