Emergency Medicine Simulation Workbook. Группа авторов

M. Wares, MD Department of Emergency Medicine Carolinas Medical Center, Atrium Health Charlotte, NC, USA

Abbreviations

      CLINICAL COMPETENCIES

ICSinterpersonal and communication skillsMKmedical knowledgePBLpractice‐based learning and improvementPCpatient carePCprofessionalismSBPsystems‐based practiceABCairway, breathing, and circulationACEangiotensin‐converting enzymeACGMEAccreditation Council of Graduate Medical EducationACLSAdvanced Cardiovascular Life SupportAFatrial fibrillationAHAAmerican Heart AssociationAISacute ischemic strokeAKIacute kidney injuryALTalanine aminotransferaseARDSacute respiratory distress syndromeASTaspartate aminotransferaseBIPPVnon‐invasive positive pressure ventilationBVMbag–valve maskBVMbag‐valve‐maskCIWAClinical Institute Withdrawal AssessmentCNScentral nervous systemCPRcardiopulmonary resuscitationCRPC‐reactive proteinCSFcerebrospinal fluidCTcomputed tomographyCTAcomputed tomography angiographyD5W5% dextrose in waterDCdirect currentDCVdirect current synchronized cardioversionDICdisseminated intravascular coagulationDRCDemocratic Republic of the CongoECGelectrocardiogramEDemergency departmenteFASTextended Focused Assessment with Sonography in TraumaEMSemergency medical servicesEVDEbola virus diseaseFASTFocused Assessment with Sonography in TraumaFDAFood and Drug AdministrationFEUfibrinogen‐equivalent unitsFFPfresh frozen plasmaGABAγ‐aminobutyric acidGCSGlasgow Coma ScaleGIgastrointestinalHAPEhigh‐altitude pulmonary edemahpfhigh power factorHPVhuman papillomavirusHSPHenoch–Schönlein purpuraHUShemolytic uremic syndromeICHintracerebral hemorrhageICUintensive care unitIMintramuscularINRinternational normalized ratioIOintraosseousIOintraosseousITPimmune thrombocytopenic purpuraIVintravenousKClpotassium chlorideLDHlactate dehydrogenaselpflow power factorLRlactated Ringer's solutionLRINEClaboratory risk indicator for necrotizing fasciitisLVOlarge vessel occlusionMACmultilumen access catheterMAHAmicroangiopathic hemolytic anemiaMCAmiddle cerebral arteryMCVmean corpuscular volumeMRImagnetic resonance imagingMRSAmethicillin‐resistant Staphylococcus aureusMTPmassive transfusion protocolNAATnucleic acid amplification testNECnecrotizing enterocolitisNICUneonatal intensive care unitNIHSSNational Institutes of Health Stroke ScaleNMDAN‐methyl‐D‐aspartateNPOnil per os (by mouth)NSAIDnonsteroidal anti‐inflammatory drugPCCprothrombin complex concentratePCRolymerase chain reactionPEApulseless electrical activityPEEPpositive end‐expiratory pressurePICUpediatric intensive care unitPICUpediatric intensive care unitPPEpersonal protective equipmentPPHpostpartum hemorrhagePSIpercutaneous sheath introducerPTTpartial prothromboplastin timeQRSno expansionqSOFAQuick Sequential [Sepsis‐related] Organ Failure AssessmentRAright atriumROSCreturn of spontaneous circulationRSIrapid sequence intubationRVRrapid ventricular rateSAFEsexual assault forensic examinerSBPsystolic blood pressuresSCDsickle cell diseaseSCFEslipped capital femoral epiphysisSCORTENSCORe of toxic epidermal necrolysisSTIsexually transmitted infectionsSVTsupraventricular tachycardiaTENtoxic epidermal necrolysisTLStumor lysis syndromeTTPthrombotic thrombocytopenic purpuraTXAtranexamic acidVTventricular tachycardiaWPWWolff–Parkinson–Whiteμlmicroliter (not mcl)

About the Companion Website

      This book is accompanied by a companion website.

      www.wiley.com/go/thoureen/simulation/workbook2e

      This website includes:

       Video clips

       Imaging and laboratory results – presented in Powerpoint format for easy download

Introduction

      Simulation has become increasingly prevalent in healthcare education, and particularly in emergency medicine education, over the past few decades [1]. It is a way to provide a safe environment for the application of knowledge and is therefore useful for undergraduate and graduate medical education, as well as for continuing professional development for physicians. Nurses and allied health professionals also use simulation‐based learning as an educational tool [2].

      Simulation‐based learning has been shown to have positive effects on the growth of complex skills across many domains of higher education [3]. Competencies that are frequently taught with simulation include procedural skill acquisition, patient safety, communication, and interprofessional team training [2]. One meta‐analysis found that simulations with high authenticity have greater effects than simulations with low authenticity [3]. It is therefore important to design realistic simulations with appropriate competency acquisition in mind.

      The goal of this workbook is to help educators perform realistic simulation experiences with practical learning objectives for students, junior and postgraduate learners. The workbook was designed with the basic clinical competencies of emergency medicine physician trainees in mind, but the cases throughout may be incorporated into a curriculum for nurses, physician assistants, or paramedics. The chapters incorporate topics listed by the American Board of Emergency Medicine as included in the certification examination. Each chapter includes three individual simulation cases that highlight subject material pertinent to the chapter topic. Changes for the second edition of this book include almost entirely new case content, the addition of one pediatric case per chapter, and, when applicable, alternative options to make cases adaptable for prehospital provider education.

For ease of use, the presentation format for each individual simulation case is uniform. Each case starts with specific educational objectives and suggested critical actions. For those working within the United States postgraduate training system, the relevant Accreditation Council of Graduate Medical Education (ACGME) clinical competencies are included. These are (together with the abbreviations used in the chapters) medical knowledge, patient care (PC), systems‐based practice (SBP), professionalism (P), interpersonal and communication skills (ICS), practice‐based learning and improvement (PBL).

      Following the critical actions, you will find an outline for the case set‐up. This includes a description of the physical environment, mannequin, props, distractors, and actors recommended for each simulation. An online resource is provided, which includes imaging and laboratory studies pertinent to each case. These multimedia images can be shown in real time on computer screens/monitors during the simulation session.

      Next, you will find a brief narrative of the case. There is a description of the initial mannequin conditions and a case narrative, which details the changes in condition that occur after a specific time interval or in response to learner actions. Accompanying flow diagrams also outline the general sequence of actions for each case. In many of the cases, alternative options are described for use with varying levels of learners (e.g. a simple scenario for junior learners with a more difficult scenario for advanced learners).

      At the end of each case you will find information to aid in debriefing. Instructor notes provide preceptors with basic background information about each specific case topic. There is also a list of potential questions for your learners to discuss during debriefing. Finally, you will also see a list of selected readings and/or references for each case. These can be distributed to learners either prior to or following the simulation.

      We hope that you find this workbook useful for your emergency medicine simulation curriculum. Keep in mind that each simulation case is dynamic and can be modified in a variety of ways to best suit your learners and/or the fidelity of your mannequin.

REFERENCES

      1 1 Okuda, Y., Bond, W., Bonfante, G. et al. (2008). National growth of simulation training within emergency medicine residency programs 2003‐2008. Acad. Emerg. Med. 15 (11): 1113–1116.

      2 2 Qayumi, K., Pachev, G., Zheng, B. et al. (2014). Status of simulation in health care education: an international survey. Adv. Med. Educ. Pract. 5: 457–467.

      3 3 Chernikova, O., Heitzmann, N., Stadler, M. et al. (2020). Simulation‐based