Nandate, Koichiro MD, PhD; Abola, Ramon MD; Murray, W Bosseau MB; Whitfield, Carol PhD; Lang, Charles PhD; Sinz, Elizabeth MD. There are just a few more things to do. Depending on scenario complexity, team dynamic and treatment modalities, this simulation may take 1020 minutes. Some error has occurred while processing your request. Revisit history taking to explore relevant medical history and identify any precipitating factors for DKA. She is lethargic and slightly confused but can intermittently respond to questions. Many of the preclinical students have never seen a real life clinical monitor or even an intravenous (IV) setup. The diabetes with DKA clinical pathway is a detailed plan of the course of care for pediatric patients seen in the emergency department with diabetic ketoacidosis. See ourCXR interpretation guidefor more details. However, this leads to confusion. doi: 10.7759/cureus.1286.
PDF Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario You may need further help or advice from a senior staff member and you shouldnot delay seeking help if you have concerns about your patient. If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. Trainee will increase knowledge of professional behaviors during the simulation.
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Classroom Dynamics
In the meantime, you can perform some basic airway manoeuvres to help maintain the airway whilst awaiting senior input.
PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency may email you for journal alerts and information, but is committed
Use an effectiveSBARR handoverto communicate the key information effectively to other medical staff. In other words, they do not have clinical experience, but they have clinical knowledge. The file explaining the session is sent to instructors 1 week before the sessions. - Geeky Medics OSCE App: https://geekymedics.com/geeky-medics-app/ You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. Invasive monitors, including a left radial intraarterial and a right subclavian IV catheter, were placed.
PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency - Cureus You should have another member of the clinical team aiding you in your ABCDE assessment, such a nurse, who can perform observations, take samples to the lab and catheterise if appropriate. endobj
Before trainees arrival into the simulation area, the simulator is already preprogrammed for DKA. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. We are looking for declaration of DKA and request for pathway. We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. PBL in our institution is implemented as a small group (n 68 students) self study session with a facilitator, who incrementally discloses further information about the patient. 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. The instructor should have visual access via one-way windows or cameras. Management of diabetic ketoacidosis in adults. Insert at least onewide-bore intravenous cannula(14G or 16G) and take blood tests as discussed below. A chest X-ray should not delay the emergency management of DKA. In an animated lecture, its important that the student group have an instructor so they can ask direct questions. Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. Simulation-based medical education: An ethical imperative. Groups of fewer than four students dont allow for optimal collaboration. As with the animated lecture, the simulation is strongly dependent on a focused case study. Make sure tore-assessthe patient after anyintervention.
KDCA for FSX - Fly Away Simulation The relationship between sleep, fatigue and patient and provider safety. This field is for validation purposes and should be left unchanged. TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. An animated lecture may be described as a pseudo-simulation environment. Terms of Use. You may be trying to access this site from a secured browser on the server. Twitter: http://www.twitter.com/geekymedics Two abstracts related to sleepiness in the EMS workforce were presented at the National Association of EMS Physicians symposium in January. Perform urinalysis and send the urine for culture if urinary tract infection is suspected. The instructors role is to facilitate active learning through a combination of learning styles. The files are given in full in the web supplement (Appendix B, Supplemental Digital Content 2, https://links.lww.com/SIH/A2). You may search for similar articles that contain these same keywords or you may
If the patient has COPD and a history of CO2retention you should switch to aventuri maskas soon as possible andtitrate oxygen appropriately. Margolis GS, Romer GA, Fernandez AR, et al. 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. This environment doesnt allow the student to identify presentation cues, be active in their own learning or apply their skills without endangering the lives of patients.(2). Stage 1: Initial assessment of acutely unwell pregnant woman and diagnosis of DKA. They should be used in conjunction with the maneuvres mentioned above as the position of the head and neck need to be maintained to keep the airway aligned. Schneider Sarver PA, Senczakowicz EA, Slovensky BM. Weight, Height: Not given, normal appearing (as per simulator) but has lost 20 lbs recently. We do not use passive visualizing materials such as videotapes or DVD other than vital signs shown on the monitors. Works with Traffic 2005, but . If the patient isunconsciousorunresponsive, start thebasic life support(BLS)algorithmas per resuscitation guidelines. Circulating nurse in the emergency room (ER). The patient synopsis should include such standard aspects as age, sex, ethnicity, medical history, medications and allergies. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. You might also be interested in our awesome bank of 700+ OSCE Stations. If you have any scenarios you would be willing to share with the simulation community, please forward them to me. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. 3. SimMan offers you the ability to provide simulation education to challenge and test your students clinical and decision-making skills during realistic patient care scenarios. Scenario in a Nutshell Diabetic ketoacidosis (DKA) in pregnancy. If the patient has clinical signs ofanaphylaxis(e.g. NPAs should not be used in patients who may have sustained a skull base fracture, due to the small but life-threatening risk of entering the cranial vault with the NPA. oral fluids, intravenous fluids, urine output, drain output, stool output, vomiting) to inform resuscitation efforts. DO NOT perform any examination or procedure on patients based purely on the content of these videos. Deteriorationshould be recognised quickly and acted upon immediately. After initial insulin therapy has reduced plasma blood glucose levels (e.g. Insert the oropharyngeal airway in the upside-down position until you reach the junction of the hard and soft palate, at which point you should rotate it 180. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. }HyEf,#$/JSRU9+CF6k\'/z+i`[
5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! The DKA simulation incorporates cue recognition, analysis of cues, generation of solutions, nursing interventions, and evaluation of outcomes, including effective communication and psychosocial concerns. COVID-19 Screening in the Pediatric Emergency Department. Despite this increased calorie intake, she noticed an unexplained 20 lbs weight loss. Example: If the provider immediately evaluates blood glucose, then the reading will display 45 mg/dL. An events progression section should include patient status changes, as well as a time/treatment continuum that incorporates if-then event progressions.
Scenarios thesimtech Introduction: This simulation on diabetic ketoacidosis (DKA) in the obstetric population presents learners with one of the more commonly encountered etiologies of critical illness in the pregnant patient. 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 use of a simulated, evolving case scenario was an effective method of exposing nursing students to complex patient care. 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. A well-staged environment allows for greater student buy-in. She had developed nausea, extreme fatigue, mild disorientation, and blurred vision toward the end of the soccer match. See ourhistory taking guidesfor more details. Ketones show 5.5. 1 Potassium losses occurring both before and during treatment of DKA must be replaced. Abstract Introduction: This simulation on diabetic ketoacidosis (DKA) in the obstetric population presents learners with one of the more commonly encountered etiologies of critical illness in the pregnant patient. When erroneous treatment is delivered, the instructor can end the simulation. For similar reasons, we do not believe a videotaped session will keep the students attention as much as these live simulator sessions. Performing an ECG should not delay the emergency management of DKA. Check out our other awesome clinical skills resources including: She began experiencing progressively worsening thirst, increased appetite, and excessively increased urination. a simulation training session designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis (DKA) through the use of simulation. 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. Acad Med. 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Child Course - Nursing EducationAuthor / Institution: Kelly McMunnclick here to download, Topic: PEA Arrest (pulseless electrical activity)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Pelvic FractureTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: Penetrating Thoracic TraumaTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: PneumoniaTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: PneumoniaTitle: Community Acquired PneumoniaTarget: PGY1Author / Institution: Iain Arseneau, Babar Haroon / Dalhousie Universityclick here to download, Topic: Pulmonary EmbolismTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Ruptured Ectopic PregnancyTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: SepsisTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: SepsisTitle: Sepsis - Crohn's IntraabdominalTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: SepsisTitle: Sepsis - DKA and PneumoniaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: SepsisTitle: Sepsis - Febrile NeutropeniaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: ShockTitle: Blunt Trauma Causing a High Spinal Cord Injury with Neurogenic ShockTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: ShockTitle: Hemorrhagic Shock in an Elderly Pedestrian stuck by a VehicleTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: ShockTitle: Penetrating Chest Trauma Causing Obstructive ShockTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Snake BiteTarget: ER residentsAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: Status AsthmaticusTarget: PGY1Author / Institution: Unknownclick here to download, Topic: Status Epilepticus - 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Hydrofluoric Acid BurnsTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Toxicology - OrganophosphatesTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Upper GastrointestinalI BleedTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Upper Gastrointestinal BleedingTitle: GI BleedTarget: PGY1Author / Institution: Babar Haroon / Dalhousie Universityclick here to download, Topic: Viral bronchiolitis in infants requiring intubationTitle: Apnea in the infant with RSV bronchiolitisTarget: Pediatric ResidentsAuthor / Institution: Mike Storrclick here to download.