Facebook: http://www.facebook.com/geekymedics 2 The evaluation of potassium deficits is complicated by potassium exit from . - Over 3000 Free MCQs: https://geekyquiz.com/ Nandate, Koichiro MD, PhD; Abola, Ramon MD; Murray, W Bosseau MB; Whitfield, Carol PhD; Lang, Charles PhD; Sinz, Elizabeth MD. We have spent many hours debating whether the small group format was a waste of time. . Finally, we summarize the course and give them time for questions. Vital Signs: BP, 90/30 mm Hg (ECG shows normal sinus rhythm); central venous pressure, 0 to 2 cm H. Lungs: All lung fields are clear to auscultation without wheeze or rhonchi, and the respiratory pattern is typical of Kussmaul breathing, ie, large deep tidal volumes and increased respiratory rate. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, Get new journal Tables of Contents sent right to your email inbox, SIH_13_4_2018_08_03_KOBAYASHI_17-00153_SDC5.tif; [Other] (3.04 MB), SIH_4_4_2009_10_29_NANDATE_200199_SDC2.doc; [Word] (68 KB), SIH_4_4_2009_10_29_NANDATE_200199_SDC3.doc; [Word] (29 KB), SIH_4_4_2009_10_29_NANDATE_200199_SDC4.doc; [Word] (40 KB), Simulation of Diabetic Ketoacidosis for Cellular and Molecular Basics of Medical Practice, Articles in PubMed by Koichiro Nandate, MD, PhD, Articles in Google Scholar by Koichiro Nandate, MD, PhD, Other articles in this journal by Koichiro Nandate, MD, PhD, Privacy Policy (Updated December 15, 2022). Trainee will be respectful to others and their views during the PBL session. In other words, they do not have clinical experience, but they have clinical knowledge. In the simulated environment, trainees will ask questions on how to interpret the data that they observe on the monitors and interpretation of clinical signs and symptoms on the manikin. The instructions to the facilitators suggest a series of structured, sequential questions to the students (starting at one end, involving each student in turn, and repeatedly cycling around the group.) Each PBL case typically goes over 23 days, affording the students periods to find information for the case. Simulation-based medical education: An ethical imperative. Make sure to re-assess the patient after any intervention. 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. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ This is a combination of the modified traditional lecture within scenario-based learning. - Onset 01:48 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. 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. 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. Patients with DKA require fluid resuscitation to restore circulatory volume, clear ketones, correct electrolyte abnormalities and increase renal perfusion. You might also be interested in our awesome bank of 700+ OSCE Stations. A strong emphasis is placed on the focused, methodical examination of a specific medical problem and the decision-based treatment options available. A patient presenting with altered level of consciousness and a blood sugar level below 80 mg/dL should be considered hypoglycemic, and treatment modalities should be consistent with those for a diabetic patient. The instructors never expect the trainees to exhibit full understanding of pathophysiology and skills in the treatment but do give them a few important points to understand the diagnosis and initial treatment of the patients with DKA. dq-]gX4 `L'u7myx) rpjf0z,.y`VMyx-&Ju`U0 Healthcare Students' Psychological Well-Being in a Diabetic Ketoacidosis Simulation. Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most common in patients with type 1 diabetes in particular due to a deficiency or absence of insulin [1].. The purpose of this simulation is to demonstrate the specific clinical signs of the patients with DKA, and the keys by which we recognize DKA in the early stages. 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. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better. Subscribe to our newsletter to be the first to know about our latest content: https://geekymedics.com/newsletter/ The students mentioned that they did not obtain the maximum value from the simulation session under these circumstances. NPAs are typically better tolerated in patients who are partly or fully conscious compared to oropharyngeal airways. We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. Clearlydocument your ABCDE assessment, including history, examination, observations, investigations, interventions, and the patients response. DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. Both external and internal potassium balances are disturbed during the development and treatment of DKA. - Introduction 00:00 Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario From the Department of Anesthesiology, Pennsylvania State University College of Medicine, Hershey, PA. Dr. Murray is on the Speakers Bureau of METI, Sarasota, FL. Ketones show 5.5. If the patient is conscious, sit themuprightas this can also help with oxygenation. We demonstrate to the trainees the significant changes on the monitors by asking them to point out any changes on the simulator (clinical examination) and the vital signs (monitor parameters). doi: 10.7759/cureus.1286. For instance, one of the questions is: Why is Tiffany dehydrated? There are several possible reasons and mechanisms (as outlined in Appendix B, fourth 15 minutes, Supplemental Digital Content 2, https://links.lww.com/SIH/A2), which the students can mention. In this case scenario, dehydration is one of the most serious immediate issues. This field is for validation purposes and should be left unchanged. cellulitis). Many of the preclinical students have never seen a real life clinical monitor or even an intravenous (IV) setup. If an infection is suspected, IV antibioticsshould be administered as soon as possible. Therefore, we should not have to take much time on this issue, but we have to focus on the relationship between the biochemistry and clinical signs and symptoms by asking why the patient is dehydrated, why acidosis develops, why respiration is rapid and deep (Kussmaul) respirations, and what the rationale for inpatient treatment is. x]o ]?9kgq~:)?hE )R6!up}\<8||\]}Y~;xp~yQ$#4~djX&{n_m-]^K1/~/AD Hv 99evs,;8}8zwnhFxV.kf-V^? For example, you could develop a diabetic scenario in which the prehospital provider encounters an altered patient with incomprehensible speech. DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. An oxygen mask is also demonstrated as an alternative device, as these early trainees had mostly not yet seen any of these devices. When erroneous treatment is delivered, the instructor can end the simulation. The instructor should have visual access via one-way windows or cameras. If any obstruction is encountered, remove the tube and try the left nostril. Perform urinalysis and send the urine for culture if urinary tract infection is suspected. YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LjMxakdNallNcng0, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkJPVjVZMzBKczY4, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkxEM2VkQzB2NTBr, Start typing to see results or hit ESC to close, Deep Vein Thrombosis (DVT) Examination OSCE Guide, Pre-hospital Advanced Life Support (ALS) OSCE Guide, Adult Choking (Basic Life Support) OSCE Guide, Paediatric Intravenous Cannulation OSCE Guide, Intrauterine System (Mirena) Counselling OSCE guide, Geeky Medics OSCE Book | Clinical Examination, Paediatric Gastro-oesophageal Reflux Disease, A Career as a GP with Special Interest with Dr Fiona Mosgrove, Absolute insulin deficiency (e.g. Typically potassium levels should be maintained between 4.0 5.5 mmol/L and close monitoring is required. 2. Laschinger S, Medves J, Pulling C, et al. Assess the patients pulse and blood pressure: Inspect the patient from the end of the bed: they may appear drowsy, confused and/or clammy/pale. In the final 10 minutes, we show how the patient has a good recovery after fluid replacement. Margolis GS, Romer GA, Fernandez AR, et al. This article originally appeared in March 2011 JEMS as Diabetes Demonstration: Simulation-based learning works best., Simulation Training Ideal for Diabetic Patients, CMS Begins Reprocessing Retroactive Payments, Documents Detail EMTs Failure to Aid Tyre Nichols, New Course Lets Bystanders Be the Help Until Help Arrives, All Paramedic Recruits in New Castle County (DE) Obtain NRP Certification, International Prehospital Medicine Institute Literature Review, March 2023. Properly interpret a venous blood gas (VBG) and basic metabolic panel in a patient presenting with diabetic ketoacidosis. Inspect the urine currently in the catheter bag and note its appearance (e.g. A nasopharyngeal airway is a soft plastic tube with a bevel at one end and a flange at the other. Heart: S1 and S2 within normal limits; no S3/S4 or murmurs, normal rate and rhythm. Should any changes be made to the current management of their underlying condition(s)? Trainee will recognize the need for therapy and suggest an appropriate therapy in a simulated environment. Generaltipsfor applying anABCDEapproachin an emergency setting include: Acute scenarios typically begin with abriefhandoverfrom a member of thenursing staffincluding thepatients name,age,backgroundand thereasonthereviewhas been requested. We then start the DKA state. See Appendix D, Supplemental Digital Content 4, https://links.lww.com/SIH/A4. Forty percent of respondents reported excessive daytime sleepiness. 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. SimMan Nursing Scenarios Software. Performing an ECG should not delay the emergency management of DKA. Open the patients mouth to ensure there is no foreign material that may be pushed into the larynx. The simulation experience serves to give substance to the theoretical words and concepts that the students encountered during the PBL sessions. For diabetic assessment involving DKA, staging may include the use of a container with a small amount of acetone placed near the manikin because many students may not know what acetone smells like but will expect to smell something. Two abstracts related to sleepiness in the EMS workforce were presented at the National Association of EMS Physicians symposium in January. The reason for inserting the airway upside down initially is to reduce the risk of pushing the tongue backwards and worsening airway obstruction. vD0 x@FFJ{m[ 3//Oh|JR7! A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. Before trainees arrival into the simulation area, the simulator is already preprogrammed for DKA. Scenarios. Note that if-thens must also include negative patient outcomes for when the provider doesnt take appropriate action. You may search for similar articles that contain these same keywords or you may During the debriefing process that follows the simulation, well-balanced performance measures will guide feedback toward accomplished tasks and may illustrate existing decision-making, behavioral or technical skill deficits. An animated lecture may be described as a pseudo-simulation environment. The consequences (low blood pressure, high heart rate, central nervous system status, etc.) Its absolutely necessary to follow all immersive simulations with a positive, emotionally safe and nonjudgmental debriefing environment. The Theory Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department | Children's Hospital of Philadelphia Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario Cureus. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. The students have acquired all the applicable theoretical knowledge of the case during the previous multiday PBL sessions. Yes: if the patient can talk, their airway is patent and you can move on to the assessment of breathing. Schneider Sarver PA, Senczakowicz EA, Slovensky BM. You may be trying to access this site from a secured browser on the server. Refer to your local guidelines which should provide a clear protocol for the management of DKA. 2011;15:108109. In the context of DKA, a patients consciousness level may be reduced. 3. Using the arterial line, the scenario becomes much more dynamic. Extremities: mild cyanosis, no clubbing or edema (verbalized by instructors); pulses equal, and symmetrical (elucidated by trainees). Introduction: Diabetic ketoacidosis (DKA) is a life-threatening illness which classically presents with polyuria, polydipsia, and polyphagia that can rapidly progress to severe dehydration and altered mental status from cerebral edema. Several environments may be suitable for your classroom. One of the key differences with the immersive simulation is that the instructor is absent from the simulation environment. Much time was wasted explaining why it did not matter. Refer to your local guidelines for further details. - Timing 03:23 A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. JEMS. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. We believe it is important to have active, participatory learning by having conversations with the trainees in the form of questions and answers. Terms of Use. Some error has occurred while processing your request. An integral part of a PBL session is for trainees to be able to navigate through huge literature bases. MassBay EMS Program Integrates Training for Dogs, Heat Waves Are Killing More LA Homeless People. She had developed nausea, extreme fatigue, mild disorientation, and blurred vision toward the end of the soccer match. Consider any precipitating factors for the development of DKA and involve the diabetes team in the patients care. 4. Emergency medical services workLife characteristics contribute to clinically significant excessive daytime sleepiness. Urinary tract infections are a common DKA precipitant. 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. Categories: Emergency Medicine, Medical Education Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine . Mosby:Philadelphia. *=NdL/c2XSJn8:I Jb8'.8>N*[L .hxw6afq40DX3c~>abt'Q,8y(BZu(vKBTufIR. Assess the patients level of consciousness using the AVPU scale: If a more detailed assessment of the patients level of consciousness is required, use the Glasgow Coma Scale (GCS). Available from: [, NICE guidelines. Circulating nurse in the emergency room (ER). Check out our other awesome clinical skills resources including: The objective is to give as many visual and tactile cues concerning the patient condition and background as possible. The students are in their first year. Simulation in Healthcare4(4):232-236, Winter 2009. Furthermore, we demonstrate and explain the basic parameters (ECG, SpO2, BP, capnography), using an interactive format of questions and answers, and encourage the group to observe the normal values. Adds true to life parking codes and extra parking for AI. Revisit history taking to explore relevant medical history and identify any precipitating factors for DKA. 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. >> Patterson PD, Weaver M, Frank R, et al. The instructors role is to facilitate active learning through a combination of learning styles. can be reemphasized, and the effects of fluid therapy demonstrated. Immersive simulations are mentally exhausting because they create an intense and stressful atmosphere requiring the learner to work outside their comfort zone. Wolters Kluwer Health The student group should be encouraged to collaborate on management options and to perform skills. Data Description All the product records are stored at /user/spark/dataset/retail_db/products All the category records are stored at /user/spark/dataset /ret. Ask for anotherclinicalmemberofstafftoassistyou if possible. Deteriorationshould be recognised quickly and acted upon immediately. DOWNLOAD Diabetic Ketoacidosis By the end of this scenario, the learner will be able to: 1. This style also doesnt mimic an actual scene, and a student may feel that treatment modalities and skills are performed at a slower rate than real-world applications. The trainees have had background knowledge of biochemistry because they had completed the PBL case. 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 . The patient was placed in the supine position and was a little confused as well as drowsy but at times had a good verbal response (Glasgow Coma Scale 15/15). Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. . 3 0 obj See Table 4 for a suggested standardized script. If the patient has COPD and a history of CO2retention you should switch to aventuri maskas soon as possible andtitrate oxygen appropriately. As this is a PBL session, the trainees are not given any references. In the meantime, you can perform some basic airway manoeuvres to help maintain the airway whilst awaiting senior input. Ziv A, Wolpe PR, Small SD, et al. Example: If the provider immediately evaluates blood glucose, then the reading will display 45 mg/dL. In this manner, the students have to apply their knowledge at the appropriate points during the progression of the scenario. 2003;78:783788. Diabetic ketoacidosis (DKA) is a common, potentially lethal disease. An arterial blood gas (ABG) can provide lots of useful information to guide management including: A chest X-ray may be indicated if abnormalities are noted on auscultation (e.g. A comprehensive collection of medical revision notes that cover a broad range of clinical topics. After the first voluntary session in 2006, feedback from the medical students indicated that they would like to receive this handout. Calculate the patients current fluid balance using their fluid balance chart (e.g. Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. TikTok: https://www.tiktok.com/@geekymedics - PSA Question Pack: https://geekymedics.com/psa-question-bank/ If foreign material is present, attempt removal using suction. Alert a senior immediately if you have any concerns about the consciousness level of a patient. Management of diabetic ketoacidosis in adults. 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. See ourintravenous cannulation guidefor more details. 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). 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. General: Moaning, asking what has happening to her. Other details are also important, including descriptions regarding patient language skill, social history, socioeconomic history, family history, religious practices or beliefs pertinent to treatment, and descriptive signs and symptoms. See ourCXR interpretation guidefor more details. Review the patients drug chart for medications which may cause a reduced level of consciousness (e.g. diagnosis of DKA Trigger 3, ABG show acidosis and high BM and normal potassium. 2010;49:578586. An hour was . 1. 1. Because of this consciousness status, it is very difficult to obtain information of cardiovascular, pulmonary, renal, hepatic, endocrine, hematology, or coagulation status other than uncontrolled diabetes. After entering the environment, the student doesnt have the option of leaving the simulation until the learning objectives and performance measures are achieved. 3. 2007. The HFS-DKA simulation teaching consisted of pre-briefing (an hour), running simulation (30 minutes) and debriefing (an hour) for the high-fidelity simulator using the Lardeal SIM man . ABG, venepuncture). opioids, sedatives, anxiolytics, insulin, oral hypoglycaemic medications). TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. We do have a wig that we place on the patient, but we do not try for full realism. For instance, if we mimicked the noise and traffic of a real emergency department, this would constitute excessive realism, and become a distraction to beginner medical students. 1 Potassium losses occurring both before and during treatment of DKA must be replaced. This typically involves the use of anon-rebreathe maskwith an oxygen flow rate of15L. A collection of surgery revision notes covering key surgical topics. The simulation session is also hosted as an interactive session. Prehosp Emerg Care. Conclusions This technical report describes the design and implementation of a simulation scenario on DKA for emergency medicine trainees. Airway adjuncts are often helpful and in some cases essential to maintain a patients airway. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Please try again soon. These simulation sessions seem to work because the medical students do have prior knowledge. #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals, Cardiovascular History Tips - DON'T FORGET these 3 things . Initially, we had a white board available, but the temptation (and habits) were just too strong, and the simulator sessions tended to become one way lectures, rather than an interactive, 2 way discussion.. 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. your express consent. Recognize the signs and symptoms of a patient presenting with diabetic ketoacidosis. However, this turned out to be too slow, took too much time, and could not continuously demonstrate the direction of changes. Twitter: http://www.twitter.com/geekymedics PA EMT Said COVID Patient Didnt Need to Go to the Hospital. Just place the BR2_KDCA file into your addons scenery folder: C:\\Program Files\\Microsoft Games\\Microsoft Flight Simulator X\\Addon Scenery\\Scenery. 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. Clinical Simulation in Nursing, Volume 39, 2020, pp. Well done, youve now stabilised the patient and theyre doing much better. Please enable scripts and reload this page. DO NOT perform any examination or procedure on patients based purely on the content of these videos. Physician working in the emergency department. This leads to hyperglycaemia, osmotic diuresis, and dehydration. angioedema, rash) commence appropriate treatment as discussed in ouranaphylaxis guide. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of . There are several causes of DKA, which we remember by the "five I's". She does not take this regularly. Stage 2: Emergency management of DKA and consideration of abnormal CTG. DO NOT perform any examination or procedure on patients based purely on the content of these videos. "Never doubt that a small group of thoughtful, committed citizens can change the world. Does the patient need a referral toHDU/ICU? Keyword Highlighting Over the years, some groups happened to have the simulation session before the completion of the theoretical PBL session. Clearly communicate how often would you like the patients observations relayed to you by other staff members. Inspect for evidence of self-injection sites (e.g. Observe and discuss the effects of therapy in a mathematically modeled physiological simulator. The instructor can also gauge the direction the debriefing session should follow or be alerted to possible problems or conflicts in treatment opinions. It may be necessary toexposethe patient during your assessment: remember to prioritise patient dignity and conservation of body heat. Medical Simulation Scenarios are text documents outlining the various details of a simulation - everything from patient simulator settings to debriefing notes. Regardless of the underlying cause of airway obstruction, seekimmediate expert supportfrom an anaesthetist and the emergency medical team (often referred to as the crash team). Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. Rosens Emergency Medicine: Concepts and Clinical Practice. Intubation lubricants can mimic drooling. DOI 10.7759/cureus.1286. Immersive Simulations Capillary refill timemay be prolonged if the patient is hypovolaemic. reduced air entry, coarse crackles) to screen for evidence of pneumonia. Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. If the patient loses consciousness and there are no signs of life on assessment, put out a crash call and commence CPR. The 60 minutes training time consists of four 15-minute sections divided as follows. Available from: [. . At the end of the previous section, the trainee can make the diagnosis of DKA but has not confirmed it yet. We introduce the Simulation Laboratory and the Simulator, and demonstrate: pulses, eyes blinking, pupil constriction, gas moves in and out of mouth (place hand over mouth), chest moves up and down. Our simulated patient is a 25-year-old woman, Tiffany, who has been taken to the Emergency Department from her soccer game by her boyfriend, Adam. In the first, the authors expanded the National Registrys Longitudinal EMT Attributes and Demographic (LEADS) study by resurveying 1,600 EMS workers about their sleepiness while at work. As this is a value-added session that demonstrates new concepts, such as the vital signs on a clinical monitor, there are no assessment instruments to measure gaining of understanding. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. Animated Lecture It was As this is an interactive discussion session, any needed debriefing and/or explanation is given during the sessions. She began experiencing progressively worsening thirst, increased appetite, and excessively increased urination. A simulation training session is described designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis through the use of simulation. Topic: Abdominal TraumaTitle: Motorcycle CrashTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Adrenal CrisisTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: AnaphylaxisTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: AnaphylaxisTitle: Anaphylaxis In An InpatientTarget: PGY1Author / Institution: Alison Rodger, Babar Haroon / Dalhousie Universityclick here to download, Topic: AnaphylaxisTitle: Bee Sting In An 8 Month OldAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: ApneaTitle: Drowning In A 3 Year OldAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: Asthmatic Protocol for EDTitle: Branching Scenario: 3 Treatment Routine ER - Pediatric PatientTargets: Emergency Department Staff and Respiratory Therapy StudentsAuthor / Instituation: Carl Rod, MS, RRT, RCP, Rose State College RT Clinical Simulation Labclick here to download, Topic: Atrial FibrillationTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download plus chart documents here, Topic: Bidirectional Ventricular Tachycardia from Digoxin ToxicityTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: BradicadiaTitle: Bradycardic Arrest - Carotid Sinus MassTarget: PGY1Author / Institution: Babar Haroon / Dalhousie Universityclick here to download, Topic: BurnTitle: Cigarette FireTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: BurnTitle: Meth Lab Explosion Target: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Cardiac ArrestTarget: Inter-professional Team TrainingAuthor / Institution: Alim Nagji, Krista Dowhos / Joseph Brant Hospitalclick here to download, Topic: Chest and Abdominal TraumaTitle: Auto AccidentTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: CHF (Congestive Heart Failure)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Communication, Interpersonal Skills, Mediating Conflict Title: Managing Family Members with Different Views Target: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Crohns FlareTitle: Complicated CrohnsTarget: PGY1Author / Institution:Allen Tran / Dalhousie Universityclick here to download, Topic: Delirious, Combative / Violent Patient Management Title: DeliriumTarget: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Delivering Bad NewsTitle: Delivering Bad News after a StrokeTarget: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Difficult AirwayTitle: Ace Inhibitor AngioedemaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Difficult AirwayTitle: Difficult / Failed AirwayTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Disclosure of an Adverse EventTitle: Retained Guidewire from a Central LineTarget: ICU FellowsAuthor / Institution: Ryan Fink / OHSUclick here to download, Topic: DKA (Diabetic Ketoacidosis)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: DKATarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Dyspnea (Shortness of Breath)Title: Acute Pulmonary Edema requiring intubationTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Dyspnea (Shortness of Breath)Title: Severe Asthma requiring intubationTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Electrical StormTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download plus chart documents here, Topic: Emergent Med-Surg ResponseTitle: MET/RRT ResponseTargets: Response Teams, House Staff and Respiratory Therapy StudentsAuthor / Instituation: Carl Rod, MS, RRT, RCP, Rose State College RT Clinical Simulation Labclick here to download, Topic: EtOH WithdrawalTitle: EtOH Withdrawal SiezureTarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Febrile NeutropeniaTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Head TraumaTitle: Four Storey FallTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Head TraumaTitle: Hit by MotorboatTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: HypertensionTitle: Aortic DissectionTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: HypertensionTitle: Autonomic DysreflexiaTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Hypertensive EmergencyTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Hypertensive EmergencyTitle: Diastolic Danger Hypertensive Urgency / EmergencyTarget: PGY1Author / Institution: Hailey Hobbs, Babar Haroon / Dalhousie Universityclick here to download, Topic: HypoxiaTarget: Inter-professional Team TrainingAuthor / Institution: Devin Sydorclick here to download, Topic: Inferior StemiTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Labor and delivery, postpartum hemorrhageTitle: Normal Delivery with PPHTarget: Maternal - 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 - Apnea Post-BenzodiazepinesTitle: Seven month old with Status EpilepticusTarget: Pediatric ResidentsAuthor / Institution: Keith Gregoireclick here to download, Topic: StrokeTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: Subdural Hemorrhage Title: SDH and DOACTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: Syncope / TorsadesTitle: Syncope / Torsades in the setting of acquired prolonged QTTarget: PGY1Author / Institution:Tasha Kulai, Babar Haroon / Dalhousie Universityclick here to download, Topic: Tachycardia Rapid AFTarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Toxic Shock SyndromeTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: Toxicology - Bupivicaine OverdoseTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Toxicology - 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.
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