This case involves a 60-year-old male patient who arrives VSA in PEA after collapsing while eating dinner with family. The collateral history included that he was suspected to be intoxicated. The patient is difficult to bag with EMS. The learner will have to work through the can’t ventilate/can’t oxygenate scenario once they identify that BVM is ineffective.
Category: Respiratory
COVID-19: Difficult Airway
Mr. Johnson, a 60-year old man was found at the bottom of 3 steps at home by his wife. He is obtunded with obvious bruising to head. EMS has placed him in a C-spine collar and provided supplemental oxygen. He was swabbed for COVID yesterday due to a new cough and fever and the results are still pending.
Pediatric Asthma Exacerbation
Acute asthma exacerbations in children are extremely common. Most asthmatic exacerbations respond quickly to basic treatment with beta-agonists, anticholinergics, and steroids. This case highlights the management of those patients who need treatment that goes beyond the basics.
COPDE with Pneumothorax
A 68-year old man with COPD requiring home oxygen presents with respiratory failure. He is hypoxic, hypercarbic and agitated and will require intubation. Dissociative-dosed ketamine and BiPAP can facilitate pre-oxygenation. After a successful intubation, the high pressure alarms on the ventilator will go off. The team leader must troubleshoot the high ventilation pressures until they find and treat a tension pneumothorax.
COVID-19: Protected Intubation in the Sim Lab
This patient is in respiratory failure and requires intubation. Participants must prepare for her arrival, organize the care team, communicate effectively and secure the patient's airway according to the principles of a protected intubation.
Pediatric Airway Obstruction
This case involves an 8 year-old boy with upper airway obstruction from sausage. When indirect treatment fails, removal with Magill forceps under direct visualization is required. The patient slowly recovers after removal of foreign body but will require admission for monitoring.
COVID-19: Ambulatory Care
This case was designed during the January 2020 COVID-19 outbreak in order to assess and improve team preparedness for safely and effectively caring for a moderately ill coronavirus patient from triage through to EMS transfer out of an ambulatory care setting.
COVID-19: Respiratory Failure
This case was designed during the January 2020 COVID-19 outbreak in order to assess and improve team preparedness for safely and effectively caring for a critically ill coronavirus patient from triage through to intubation.
Nightmares Case 5: Pulmonary Edema
This case involves the approach to the patient with acute dyspnea. The patient is tachypneic, hypoxic, and hypertensive. The team should consider multiple possibilities but recognize pulmonary edema as the most likely cause.
Nightmares Case 4: Pulmonary Embolism
This case involves the approach to the patient with acute dyspnea. The patient is tachypneic but with an otherwise normal respiratory exam. ECG shows new right heart strain. The team should consider multiple possibilities but recognize PE as the most likely cause.
