dka simulation scenario

In this section, we have to guide them as to what they should do first for the patient in this critical condition (ie, treat the A, B, Cs of airway, breathing, and circulation) before we can confirm the diagnosis. Strategies of high-performing paramedic educational programs. DONT FORGET these 3 key components of the cardiovascular exam for your upcoming OSCEs Save this video to watch later and dont forget to follow Geeky Medics! Assessment & Treatment of Five Diabetic Emergencies - JEMS See ourdocumentation guidesfor more details. A nasopharyngeal airway is a soft plastic tube with a bevel at one end and a flange at the other. As a next step, we will let one of the trainees talk to the patient, and prompt to ask medical questions such as previous medical issues or recent drug use for them to practice asking questions to generate a differential diagnosis (in this case, other causes for confusion). The researchers found that long shift hours (24hrs), working overtime and marital/relationship stress were strongly correlated. Despite this increased calorie intake, she noticed an unexplained 20 lbs weight loss. Her medical, social, and family histories are not clear at the time of admission to the emergency department. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better. Could we not just do this as a large group session to all 160 students (versus 20 1-hour sessions to groups of eight students)? a simulation training session designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis (DKA) through the use of simulation. Groups of fewer than four students dont allow for optimal collaboration. 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. Using the arterial line, the scenario becomes much more dynamic. Does the patient need a referral toHDU/ICU? The students mentioned that they did not obtain the maximum value from the simulation session under these circumstances. type 1 diabetes), Complete insulin insensitivity (e.g. 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. The instructors have to appreciate that the trainees participating in this simulation have not seen a diabetic patient in either a ward or ER, but that they have knowledge of the underlying physiology. Weight, Height: Not given, normal appearing (as per simulator) but has lost 20 lbs recently. 2011;15:108109. 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. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. When a group treatment decision is made that would be contraindicated or harmful to the patient, the instructor can redirect the learner group while maintaining an atmosphere inclined toward independent thinking. The 60 minutes training time consists of four 15-minute sections divided as follows. type 1 diabetes) Complete insulin insensitivity (e.g. Depending on scenario complexity, team dynamic and treatment modalities, this simulation may take 1020 minutes. If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. Similar to a ward round, where the instructor would say: Come and listen to this patient with an aortic stenosis. Extremities: mild cyanosis, no clubbing or edema (verbalized by instructors); pulses equal, and symmetrical (elucidated by trainees). }HyEf,#$/JSRU9+CF6k\'/z+i`[ 5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! 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. - Over 3000 Free MCQs: https://geekyquiz.com/ We do not use passive visualizing materials such as videotapes or DVD other than vital signs shown on the monitors. Intubation lubricants can mimic drooling. Stage 1: Initial assessment of acutely unwell pregnant woman and diagnosis of DKA. Administer oxygen to all critically unwell patients during yourinitialassessment. TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. One advantage to the animated lecture style is the ability to introduce treatment options in a methodically guided approach thats in conjunction with simultaneous environmental stimulus. The reason for inserting the airway upside down initially is to reduce the risk of pushing the tongue backwards and worsening airway obstruction. Its important to train and educate students of prehospital care on key indicators of a diabetic emergency. A traditional classroom lecture format allows for student participation but limits the instructors ability to create realistic situations. Chapters: A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. The main goal is to establish a safe learning environment for the learner [9, 13 . x]o ]?9kgq~:)?hE )R6!up}\<8||\]}Y~;xp~yQ$#4~djX&{n_m-]^K1/~/AD Hv 99evs,;8}8zwnhFxV.kf-V^? Pediatric Emergency Medicine Didactics and Simulation (PEMDAS At the end of the previous section, the trainee can make the diagnosis of DKA but has not confirmed it yet. 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. Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. The instructor can also gauge the direction the debriefing session should follow or be alerted to possible problems or conflicts in treatment opinions. Trainee will increase knowledge of professional behaviors during the simulation. A blood glucose level may already be available from earlier investigations (e.g. Should any changes be made to the current management of their underlying condition(s)? Search for Similar Articles Many of the preclinical students have never seen a real life clinical monitor or even an intravenous (IV) setup. The lecture allows for understanding of concepts prior to action, and instructor feedback is immediate. Typically potassium levels should be maintained between 4.0 5.5 mmol/L and close monitoring is required. 2010;49:578586. Use an effectiveSBARR handoverto communicate the key information effectively to other medical staff. Debriefing *=NdL/c2XSJn8:I Jb8'.8>N*[L .hxw6afq40DX3c~>abt'Q,8y(BZu(vKBTufIR. We ask the trainee why the blood pressure is so low or heart rate is so high, and how we should treat it. 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. This simulation session therefore aims to make the case come alive, and show this known case in a clinical context. Twitter: http://www.twitter.com/geekymedics VbQuX#R M21 Manikin staging can provide strong cues. A list of the requirements (monitors, props, and others) is given in Tables 2 and 3, as well as in the web supplement (Appendix C, Supplemental Digital Content 3, https://links.lww.com/SIH/A3). Check out our other awesome clinical skills resources including: Much time was wasted explaining why it did not matter. PDF DKA Sim Scenario - ABCD (Diabetes Care) Ltd If foreign material is present, attempt removal using suction. may email you for journal alerts and information, but is committed Pediatric Emergency Medicine Didactics and Simulation (PEMDAS Case-based simulation should include two to three broad-focus objectives, as well as 1020 specific performance measures that the student should accomplish. 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. %PDF-1.5 Medical Simulation Scenarios are text documents outlining the various details of a simulation - everything from patient simulator settings to debriefing notes. Mosby:Philadelphia. This may produce better retention of the subject matter and help students adapt to emergency scenes before going into the field. Place one hand on the patients forehead and the other under the chin. Cureus 9(5): e1286. Int J Evid Based Healthc. Trainee will appropriately request assistance and use available resources. If the patient isunconsciousorunresponsive, start thebasic life support(BLS)algorithmas per resuscitation guidelines. - Timing 03:23 You may be trying to access this site from a secured browser on the server. endobj Target Learner Groups Antibiotics should be prescribed in keeping with local guidelines. ABG, venepuncture). Outcomes Educating Nursing Students Using an Evolving, Simulated Case <>>> Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. The file explaining the session is sent to instructors 1 week before the sessions. The objective is to give as many visual and tactile cues concerning the patient condition and background as possible. However, this turned out to be too slow, took too much time, and could not continuously demonstrate the direction of changes. 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. (1) The assessment of a diabetic patient is best taught as a. TikTok: https://www.tiktok.com/@geekymedics Simulation in Healthcare4(4):232-236, Winter 2009. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ We now provide the students with handouts of the data to save time and provide consistency. Glycosuria leads to urinary losses of potassium through osmotic diuresis. When erroneous treatment is delivered, the instructor can end the simulation. You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ JEMS. Diabetes UK with the Joint British Diabetes Societies Inpatient Care Group. Use washable, non-toxic paints to imitate various body emissions. . 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. She tends to drink sugar containing fluids (soda) when she is thirsty, and she eats fast foods (cream-filled muffins) when she is hungry. 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. The facilitator guides the group only when necessary. #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals, Cardiovascular History Tips - DON'T FORGET these 3 things . 2017 May 29;9(5):e1286. 3. . 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. A pre-briefing session is conducted prior to the start of the simulation scenario. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of . Immersive Simulations reduced air entry, coarse crackles) to screen for evidence of pneumonia. Patients with DKA require fluid resuscitation to restore circulatory volume, clear ketones, correct electrolyte abnormalities and increase renal perfusion. Effectiveness of simulation on health profession students knowledge, skills, confidence and satisfaction. 1. Conclusion Stage 3: Ongoing management and monitoring of DKA 1 hour after initiation of treatment. Join the Geeky Medics community: Performing an ECG should not delay the emergency management of DKA. However, we should not spend too much time on (not become distracted with) explaining unfamiliar monitors for the present trainees, such as central venous pressure or ETCO2 concentration. Review the patientscurrent medicationsand check any regular medications areprescribed appropriately.