The emergency team is preparing to perform a conscious sedation on a 7-year-old boy to facilitate the reduction of a fracture of the radius and ulna. They will be expected to do an airway assessment and pick an appropriate agent for sedation. In the middle of sedation, the patient’s oxygen saturation will suddenly drop and the patient will stop breathing. The team will be unable to bag the patient until they ask for either deeper sedation or a paralytic. If they administer succinylcholine, the patient will become bradycardic and require atropine.
Category: Resuscitation
Opioid Overdose with ARDS
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.
Massive Upper GI Bleed
A 58-year-old male known for alcoholism presents to the emergency department with an active, massive upper GI bleed due to esophageal varices. The patient deteriorates into hypovolemic shock requiring medical management, massive transfusion, intubation for airway protection, and insertion of a Blakemore tube.
Ventricular Tachycardia due to Arrhythmogenic Right Ventricular Dysplasia (ARVD)
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.
EM Sim Cases 