dka simulation scenario

Open the patients airwayusing ahead-tiltchin-lift manoeuvre: 1. The patient synopsis should include such standard aspects as age, sex, ethnicity, medical history, medications and allergies. The optimal number of simulation participants is four to seven individuals, depending on the case study objectives. Invasive monitors, including a left radial intraarterial and a right subclavian IV catheter, were placed. Deteriorationshould be recognised quickly and acted upon immediately. DY{Qb"(EgN$QI*%XN1F""0a5 J Nurs Educ. Paediatric DKA | Simulation Education For example, you could develop a diabetic scenario in which the prehospital provider encounters an altered patient with incomprehensible speech. oral fluids, intravenous fluids, urine output, drain output, stool output, vomiting) to inform resuscitation efforts. Ask for anotherclinicalmemberofstafftoassistyou if possible. Assessment & Treatment of Five Diabetic Emergencies - JEMS Patients with DKA require fluid resuscitation to restore circulatory volume, clear ketones, correct electrolyte abnormalities and increase renal perfusion. Trainee will correlate the underlying pathophysiology with symptoms and signs as exhibited by the simulation session. 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. The addition of a fluid infusion containing some potassium allows insulin therapy to continue to suppress ketogenesis and normalise plasma pH whilst preventing the development of hypokalaemia. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 2 0 obj Simulation of Diabetic Ketoacidosis for Cellular and Molecul 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. type 1 diabetes), Complete insulin insensitivity (e.g. 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. She was taken to the Emergency Department from her soccer game because she complained of nausea, extreme fatigue, mild disorientation, and blurred vision toward the end of the soccer match. 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 . SimMan Nursing Scenarios Software. With your index and other fingers placed behind the angle of the mandible, apply steady upwards and forward pressure to lift the mandible. Insert the airway bevel-end first, vertically along the floor of the nose with a slight twisting action. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. 2008;6:278302. Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. DO NOT perform any examination or procedure on patients based purely on the content of these videos. As individuals with uncontrolled type I . Physician working in the emergency department. 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. Respiratory Failure in the Course of Treatment of Diabetic Ketoacidosis Margolis GS, Romer GA, Fernandez AR, et al. Laschinger S, Medves J, Pulling C, et al. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. 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). - Site 01:12 Collectblood testsafter cannulating the patient including: An ECG should be performed to screen for cardiac pathology such as arrhythmias which may be precipitated by electrolyte abnormalities (e.g. 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. See Table 4 for a suggested standardized script. In the meantime, you can perform some basic airway manoeuvres to help maintain the airway whilst awaiting senior input. Make sure to re-assess the patient after any intervention. In an animated lecture, its important that the student group have an instructor so they can ask direct questions. Given 6 to 8 back-to-back sessions, it is critical that every session starts and ends on time! If the patient has clinical signs ofanaphylaxis(e.g. Diabetic ketoacidosis (DKA) is a common, potentially lethal disease. (1) According to Centers for Disease Control and Prevention (CDC), 223,619 deaths were attributed to diabetes in 2005. Facebook: http://www.facebook.com/geekymedics Does the patient need reviewing by a specialist? Refer to your local guidelines for further details. Finally, we summarize the course and give them time for questions. The instructors role is to facilitate active learning through a combination of learning styles. 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. His Wife Gave Him CPR. An oxygen mask is also demonstrated as an alternative device, as these early trainees had mostly not yet seen any of these devices. Strategies of high-performing paramedic educational programs. The required potassium replacement varies greatly. You may be trying to access this site from a secured browser on the server. When erroneous treatment is delivered, the instructor can end the simulation. The simulation session is also hosted as an interactive session. We ask the trainee why the blood pressure is so low or heart rate is so high, and how we should treat it. 2010;49:578586. For similar reasons, we do not believe a videotaped session will keep the students attention as much as these live simulator sessions. Does the patient need a referral toHDU/ICU? Introduceyourselfto whoever has requested a review of the patient andlistencarefullyto their handover. We have been presenting Simulation Laboratory sessions to our preclinical medical students (first and second years). Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journals Web site (www.simulationinhealthcare.com). Acad Med. 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. 1. 4 0 obj You may search for similar articles that contain these same keywords or you may We combined both to indicate the continuity of the curriculum, and the building on prior knowledge. Simulation Scenario. You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. Diabetes UK with the Joint British Diabetes Societies Inpatient Care Group. Reprints: Koichiro Nandate, MD, PhD, Department of Anesthesiology, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, 500 University Drive Box 850, Hershey, PA 17033 (e-mail: [emailprotected]). can be reemphasized, and the effects of fluid therapy demonstrated. Endocrine - thesimbook.com Cureus 9(5): e1286. The faculty member/course coordinator of Simulation Design Observe and discuss the effects of therapy in a mathematically modeled physiological simulator. Capillary refill timemay be prolonged if the patient is hypovolaemic. Example: If the provider immediately evaluates blood glucose, then the reading will display 45 mg/dL. Case-based simulation should include two to three broad-focus objectives, as well as 1020 specific performance measures that the student should accomplish. CCA 175 Real Time Exam Scenario 17 | JOIN Multiple DataFrames | Save as This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ If foreign material is present, attempt removal using suction. 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). 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. Terms of Use. Simulation Training Ideal for Diabetic Patients - JEMS Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario There are several causes of DKA, which we remember by the "five I's". Typically potassium levels should be maintained between 4.0 5.5 mmol/L and close monitoring is required. Inspect theairwayfor obviousobstruction. and to maintaining your privacy and will not share your personal information without 1-6. Instagram: https://instagram.com/geekymedics DKA can be caused by either: Absolute insulin deficiency (e.g. 2 The evaluation of potassium deficits is complicated by potassium exit from . This is a combination of the modified traditional lecture within scenario-based learning. A nasopharyngeal airway is a soft plastic tube with a bevel at one end and a flange at the other. If you have any scenarios you would be willing to share with the simulation community, please forward them to me. - Radiation 02:45 Int J Evid Based Healthc. Her medical, social, and family histories are not clear at the time of admission to the emergency department. Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ 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. In other words, they do not have clinical experience, but they have clinical knowledge. Available from: [, NICE guidelines. Scenarios. Therefore, the same file is also sent to the participants before the session. A patient with Type I diabetes will often have symptoms related to blood sugar imbalances that appear abruptly with polydipsia, polyuria, polyphagia and rapid weight loss. - Associated symptoms 03:04 Several environments may be suitable for your classroom.