Simulation Scenario for Anesthesia Providers Clark Obr, MD*, Anthony Mueller, MD *Corresponding author: clark-obr@uiowa.edu Abstract Introduction: This simulation on diabetic ketoacidosis (DKA) in . Case-based education adds a real-world aspect to the learning environment. An integral part of a PBL session is for trainees to be able to navigate through huge literature bases. See ourintravenous cannulation guidefor more details. Performing an ECG should not delay the emergency management of DKA. tall tented T waves in hyperkalaemia). DO NOT perform any examination or procedure on patients based purely on the content of these videos. Typically potassium levels should be maintained between 4.0 5.5 mmol/L and close monitoring is required. - Site 01:12 endobj If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. TikTok: https://www.tiktok.com/@geekymedics Prehosp Emerg Care. We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. A well-staged environment allows for greater student buy-in. Are any further assessments or interventions required? If foreign material is present, attempt removal using suction. The students are in their first year. Debriefing COVID-19 Screening in the Pediatric Emergency Department. modify the keyword list to augment your search. - Timing 03:23 This is a combination of the modified traditional lecture within scenario-based learning. Management of diabetic ketoacidosis in adults. The required potassium replacement varies greatly. Wolters Kluwer Health Conclusion: Our DKA simulator is a new tool whose objective is the training in a severe, frequent and complex situation, and can be used to improve the approach made by the junior physicians to the real diabetic . Published August 2015. Much time was wasted explaining why it did not matter. Development of simulation scenarios for an adolescent patient with diabetic ketoacidosis. DO NOT perform any examination or procedure on patients based purely on the content of these videos. Instructors should write a case study for the simulation before the session. PA EMT Said COVID Patient Didnt Need to Go to the NYC Unions Demand Reinstatement, Back Pay for Workers Fired for Refusing President Biden to End COVID-19 Emergencies on May 11. Below is a collection of donated scenarios for you to use or modify. Evenly balancing performance measures will ensure the student has the opportunity to critically think through patient treatment and to practice new or support previously learned behaviors and technical skills. Make sure to re-assess the patient after any intervention. Recognize the signs and symptoms of a patient presenting with diabetic ketoacidosis. The Theory (1) The assessment of a diabetic patient is best taught as a. If the patient has COPD and a history of CO2retention you should switch to aventuri maskas soon as possible andtitrate oxygen appropriately. See ourCXR interpretation guidefor more details. Trainee will recognize the need for therapy and suggest an appropriate therapy in a simulated environment. As with the animated lecture, the simulation is strongly dependent on a focused case study. Works with Traffic 2005, but . Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. This is a 25-year-old woman with a medical history of diabetes medicated with 40 units insulin per day. Despite this increased calorie intake, she noticed an unexplained 20 lbs weight loss. Askhow the patient is feeling as this may provide some useful information about their current symptoms. Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine Introduction Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most commonly occurring in patients with type I diabetes. stream The use of a simulated, evolving case scenario was an effective method of exposing nursing students to complex patient care. Immersive simulations are mentally exhausting because they create an intense and stressful atmosphere requiring the learner to work outside their comfort zone. 2. We do point out the blood pressure (BP) cuff, but these medical students in their first year do not really need to know how the BP values are generated, they need to understand the origin and therapy for the low blood pressure. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Heart: S1 and S2 within normal limits; no S3/S4 or murmurs, normal rate and rhythm. 6. - 150+ PDF OSCE Checklists: https://geekymedics.com/pdf-osce-checklists/ Prehosp Emerg Care. A nasopharyngeal airway is a soft plastic tube with a bevel at one end and a flange at the other. - Associated symptoms 03:04 . Chapters: Marx JA, Hockberger RS, Walls RM. Its absolutely necessary to follow all immersive simulations with a positive, emotionally safe and nonjudgmental debriefing environment. A pre-briefing session is conducted prior to the start of the simulation scenario. and Check the patency of the patients right nostril and if required (depending on the model of NPA) insert a safety pin through the flange of the NPA. An individual student can get an immediate answer to a question, the facilitator can see puzzled expressions on faces, and the PBL group could get answers that they could not get during their prior PBL group discussions. a simulation training session designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis (DKA) through the use of simulation. DY{Qb"(EgN$QI*%XN1F""0a5 to below 12 mmol/L) an infusion containing normal saline and 5% dextrose is typically commenced to prevent the development of hypoglycaemia, whilst allowing insulin therapy to continue to suppress ketogenesis and reduce serum electrolyte concentrations. We have been presenting Simulation Laboratory sessions to our preclinical medical students (first and second years). 2008;6:278302. The student group is given a short introduction into a closed simulation environment. The main purpose of the simulation is to draw a line from the theoretical, boring biochemistry to the clinical manifestations. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ 3. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel . Trainee will increase knowledge of professional behaviors during the simulation. We combined both to indicate the continuity of the curriculum, and the building on prior knowledge. In this case scenario, dehydration is one of the most serious immediate issues. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! cloudy urine may indicate urinary tract infection). type 1 diabetes), Complete insulin insensitivity (e.g. However, this leads to confusion. Review the patientsoxygen saturation(SpO2): Auscultate the chest to screen for evidence of respiratory pathology (e.g. The students worked on the underlying physiology during a week long PBL session and are therefore familiar with the theoretical aspects of DKA. See our blood glucose measurement guide for more details. Some manikin models support a variety of human functions, such as capillary and facial cyanosis, facial sweating, foley catheter and IV placement, blood pressure generation, cardiac rhythms and abnormalities, defibrillation, cardioversion, external pacing and vital sign generation. The faculty member/course coordinator of Simulation Design Insert at least onewide-bore intravenous cannula(14G or 16G) and take blood tests as discussed below. If any obstruction is encountered, remove the tube and try the left nostril. Immersive Simulations Note that if-thens must also include negative patient outcomes for when the provider doesnt take appropriate action. cellulitis). Use blankets to re-warm patients who are mild to moderately hypothermic. Diabetic ketoacidosis; Simulation training; Medical students. - 700+ OSCE Stations: https://geekymedics.com/osce-stations/ The immersive simulation is performed when the instructor feels comfortable with the acquired knowledge and skill base presented in the animated lecture or when the student group has sufficient practical experience to apply the cognitive, behavioral and technical skills outlined in the case scenario. Acad Med. This guide has been created to assist students in preparing for emergencysimulationsessionsas part of their training,it is not intended to be relied upon for patient care. Refer to your local guidelines for further details. DOI 10.7759/cureus.1286. - Examples 05:45 They should introduce the student group to the environment, assign roles for each learner and guide the decision-making process. The instructor can also gauge the direction the debriefing session should follow or be alerted to possible problems or conflicts in treatment opinions. The impetus for creating and implementing the high-fidelity diabetic ketoacidosis (DKA) simulation was based on a needs assessment and reviewing of undergraduate nursing students' examination statistics in a second semester medical-surgical course. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. Rosens Emergency Medicine: Concepts and Clinical Practice. 2) Complete the assigned suggested readings 3) Complete the presimulation preparation virtual simulation game (Instructor will provide link) 4) Once you have completed reading this document and prepared for your simulation, please: a. On arrival to the ER, standard monitors (electrocardiogram [ECG] and pulse oximetry [SpO2]) and end-tidal carbon dioxide (ETCO2) concentration were placed, and the patient was given oxygen by nasal cannulae. Trainee will practice or observe good teamwork skills, both as a leader and a team player. In the meantime, you should re-assess and maintain the patients airway. It involves working through the following steps: Each stage of the ABCDE approach involvesclinicalassessment,investigationsandinterventions. Does the patient need a referral toHDU/ICU? Maintain head-tilt chin-lift or jaw thrust and assess the patency of the patients airway by looking, listening and feeling for signs of breathing. Capillary refill timemay be prolonged if the patient is hypovolaemic. His Wife Gave Him CPR. General: Moaning, asking what has happening to her. The objective is to give as many visual and tactile cues concerning the patient condition and background as possible. 2 The evaluation of potassium deficits is complicated by potassium exit from . Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. Animated Lecture The authors of the second study reported that poor sleep quality (60% of respondents) and extreme fatigue (55% of respondents) are independently associated with safety risks on the job. Questionswhich may need to be considered include: The next team of doctors on shift should bemade awareof any patient in their department who hasrecently deteriorated. The students are in their basic science course. A GCS of 8 or below warrants urgent expert help from an anaesthetist. If the provider starts an IV and gives dextrose, then the patients alertness will increase, respirations will normalize and repeated blood glucose will read 210 mg/dL over a two-minute interval. DIABETIC KETOACIDOSIS MODULE: ENDOCRINOLOGY / METABOLIC TARGET: ALL PAEDIATRIC TRAINEES;NURSING STAFF BACKGROUND: DKA occurs when a relative or absolute lack of insulin leads to the inability to metabolise glucose. The main goal is to establish a safe learning environment for the learner [9, 13 . Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. The patient synopsis should include such standard aspects as age, sex, ethnicity, medical history, medications and allergies. See ourfluid prescribing guidefor more details onresuscitation fluids. Calculate the patients current fluid balance using their fluid balance chart (e.g. Refer to your local guidelines which should provide a clear protocol for the management of DKA. Does the patient need reviewing by a specialist? Therefore, the session is divided into four sections of 15 minutes each, so that the facilitator is constantly aware of being on time (or not), even after the first 15 minutes period. There are actually two sets of educational objectives: the first set is for the theoretical PBL sessions, and the 2nd set is for the Simulation Session. Healthcare Students' Psychological Well-Being in a Diabetic Ketoacidosis Simulation. Feel the slow and tardy pulse, we consider these PBL sessions as an example of a Look here, see this use of a full human simulator in the hierarchy of learning strategies with a full human simulator (Table 1). Use washable, non-toxic paints to imitate various body emissions. Surgical dressings and imitation blood can support medical history. Interactive lecture/discussion with use of monitors that show the vital signs of the simulated patient on manikin. Both external and internal potassium balances are disturbed during the development and treatment of DKA. Trigger 4, Pathway 1l of saline required over 1hour and insulin infusion need prescribing and making up in 50ml syringe. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of . Prior to starting the scenario, the instructor should introduce a short summary of the case study and ask open-ended questions regarding the management direction. Physician working in the emergency department. Make sure thepatientsnotes,observationchartandprescriptionchartare easily accessible. An oropharyngeal airway is a curved plastic tube with a flange on one end that sits between the tongue and hard palate to relieve soft palate obstruction. We are adding to their theoretical knowledge by introducing them to physical objects, dynamic moving vital sign signals, and a moving, breathing simulated patient to make the case come alive. The files are given in full in the web supplement (Appendix B, Supplemental Digital Content 2, https://links.lww.com/SIH/A2).
City Of Homewood Building Permits,
Accident M14 Plymouth, Mi,
Volleyball Clinics Honolulu,
Ac Valhalla Hash Id List,
Marvel Heroes Omega Private Server 2021,
Articles D