Instructors should write a case study for the simulation before the session. Finally, we summarize the course and give them time for questions. PDF Diabetic Ketoacidosis in the Obstetric Population: A Simulation 2007. For example, you could develop a diabetic scenario in which the prehospital provider encounters an altered patient with incomprehensible speech. This typically involves the use of anon-rebreathe maskwith an oxygen flow rate of15L. In the context of DKA, a patients consciousness level may be reduced. Conclusions This technical report describes the design and implementation of a simulation scenario on DKA for emergency medicine trainees. 2011;15:108109. Consider active re-warming techniques in patients with severe hypothermia. Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario 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. The Theory Works with Traffic 2005, but . 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. Revisit history taking to explore relevant medical history and identify any precipitating factors for DKA. 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). Facilitator to ask how often to measure BMs A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. If the patient isunconsciousorunresponsive, start thebasic life support(BLS)algorithmas per resuscitation guidelines. Published August 2015. In this case scenario, dehydration is one of the most serious immediate issues. Classroom Dynamics An animated lecture may be described as a pseudo-simulation environment. In other words, they do not have clinical experience, but they have clinical knowledge. Use an effectiveSBARR handoverto communicate the key information effectively to other medical staff. Testing a diabetes keotacidosis simulation in critical care nursing: A oral fluids, intravenous fluids, urine output, drain output, stool output, vomiting) to inform resuscitation efforts. You may be trying to access this site from a secured browser on the server. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Trainee will learn to collaborate with peers to decide on appropriate interventions, tests, and therapy. Case-based simulation should include two to three broad-focus objectives, as well as 1020 specific performance measures that the student should accomplish. Trainee will recognize and interpret the clinical signs and symptoms and the typical history of a patient with DKA, as well as understand the major causative factors of DKA. DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. 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 students are in their first year. 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 . Glycosuria leads to urinary losses of potassium through osmotic diuresis. Inspect theairwayfor obviousobstruction. After initial insulin therapy has reduced plasma blood glucose levels (e.g. 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). 1. The main purpose of the simulation is to draw a line from the theoretical, boring biochemistry to the clinical manifestations. >> Patterson PD, Weaver M, Frank R, et al. For example, if a student is to run a diabetic emergency in an extended living facility, the room should be staged with the appropriate bed, linens and medical equipment, and include personal artifacts and memorabilia normally found in such environments. The simulation experience serves to give substance to the theoretical words and concepts that the students encountered during the PBL sessions. A comprehensive collection of medical revision notes that cover a broad range of clinical topics. Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine Introduction Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most . The researchers found that long shift hours (24hrs), working overtime and marital/relationship stress were strongly correlated. 1 0 obj 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). You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. Management of diabetic ketoacidosis in adults. "Never doubt that a small group of thoughtful, committed citizens can change the world. The required potassium replacement varies greatly. Discuss the patients current clinical condition with aseniorclinicianusing anSBARR style handover. The instructors role is to facilitate active learning through a combination of learning styles. Categories: Emergency Medicine, Medical Education Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine . Schneider Sarver PA, Senczakowicz EA, Slovensky BM. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. 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. I assigned true to life parking codes, and added some extra parking for the superfluous US Express AI. Acad Med. 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). 3. Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department | Children's Hospital of Philadelphia This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. See ourCXR interpretation guidefor more details. can be reemphasized, and the effects of fluid therapy demonstrated. Does the patient need reviewing by a specialist? PDF Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario VbQuX#R M21 - Over 3000 Free MCQs: https://geekyquiz.com/ Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario 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). This is a 25-year-old woman with a medical history of diabetes medicated with 40 units insulin per day. Subscribe to our newsletter to be the first to know about our latest content: https://geekymedics.com/newsletter/ If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. We try to provide sufficient realism.. SimMan Nursing Scenarios Software - laerdal.com We have been presenting Simulation Laboratory sessions to our preclinical medical students (first and second years). Respiratory Failure in the Course of Treatment of Diabetic Ketoacidosis Simulation Scenario. 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. You might also be interested in our awesome bank of 700+ OSCE Stations. DO NOT perform any examination or procedure on patients based purely on the content of these videos. 2 0 obj 3. 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 students worked on the underlying physiology during a week long PBL session and are therefore familiar with the theoretical aspects of DKA. Patients with DKA require fluid resuscitation to restore circulatory volume, clear ketones, correct electrolyte abnormalities and increase renal perfusion. Case-based education adds a real-world aspect to the learning environment. may email you for journal alerts and information, but is committed Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. As the name says, this screen is used to graph and plot any parameter. You can plot as many parameters as you want and can choose to display either Historical data or have the graphs update as often as new data comes in and view them in Real-time. Diabetes UK with the Joint British Diabetes Societies Inpatient Care Group. and Indeed, it is the only thing that ever has.". 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. Despite this increased calorie intake, she noticed an unexplained 20 lbs weight loss. Facebook: http://www.facebook.com/geekymedics Your message has been successfully sent to your colleague. <> <> Emergency medical services workLife characteristics contribute to clinically significant excessive daytime sleepiness. Target Learner Groups 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. Section snippets . 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. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. The main goal is to establish a safe learning environment for the learner [9, 13 . You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ 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. The normal reference range for fasting plasma glucose is 4.0 5.8 mmol/l. Observe and discuss the effects of therapy in a mathematically modeled physiological simulator. Given such a small group, the students indicated that they feel more involved than they would with a larger group (eg, the whole class.) Instagram: https://instagram.com/geekymedics This is an important period, as this is where the students see the theoretical concept (metabolic acidosis), come to life as for instance large tidal volumes. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. We are looking for declaration of DKA and request for pathway. See Table 4 for a suggested standardized script. (1), The assessment of a diabetic patient is best taught as a case-based simulation. Perform urinalysis and send the urine for culture if urinary tract infection is suspected. The validity of the HFS-DKA scenario was verified by a certified diabetes nurse educator, a registered nurse, and a clinical nurse educator. After the initial treatment is initiated, by showing a simulated urine and blood, and by getting them to smell ketones, we can enable the trainee to confirm the diagnosis of DKA. The students mentioned that they did not obtain the maximum value from the simulation session under these circumstances. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Review thepatients notes,chartsandrecent investigation results. This guide provides an overview of the recognition and immediate management of diabetic ketoacidosis (DKA)using an ABCDE approach. A collection of surgery revision notes covering key surgical topics. 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]). Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. Administer oxygen to all critically unwell patients during yourinitialassessment. See ourdocumentation guidesfor more details. 2. Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. Circulating nurse in the emergency room (ER). - Timing 03:23 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 - 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