Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Often, the learner group will be unaware of these behaviors, but the instructor can key into the first few comments made during the transition between rooms. 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). Use washable, non-toxic paints to imitate various body emissions. Experience has shown that the more experienced the provider, the more detailed the environmental and manikin staging should be, because providers are trained to take in and interpret visual cues as indicators of patient status. Clinical Simulation in Nursing, Volume 39, 2020, pp. DO NOT perform any examination or procedure on patients based purely on the content of these videos. 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. She had developed nausea, extreme fatigue, mild disorientation, and blurred vision toward the end of the soccer match. PBL was introduced at our institution in 1995. 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 . Facilitator to ask how often to measure BMs Please try after some time. 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. Groups of more than seven may struggle with meeting objectives due to insufficient functional rolls. Trainee will appropriately request assistance and use available resources. If the patient is conscious, sit themuprightas this can also help with oxygenation. 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. 2 0 obj 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. (1), The assessment of a diabetic patient is best taught as a case-based simulation. Finally, we summarize the course and give them time for questions. If the patient has COPD and a history of CO2retention you should switch to aventuri maskas soon as possible andtitrate oxygen appropriately. and Twitter: http://www.twitter.com/geekymedics We try to provide sufficient realism.. Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. Instagram: https://instagram.com/geekymedics cellulitis). The consequences (low blood pressure, high heart rate, central nervous system status, etc.) Example: If the provider immediately evaluates blood glucose, then the reading will display 45 mg/dL. Categories: Emergency Medicine, Medical Education Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine . Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. This is particularly important for core . By joining Cureus, you agree to our Available if the trainee asks: arterial blood gas, glucose, electrolytes, BUN and plasma osmolality (please see last section of Appendix B, Supplemental Digital Content 2, https://links.lww.com/SIH/A2, for values). You may search for similar articles that contain these same keywords or you may 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. Conclusions This technical report describes the design and implementation of a simulation scenario on DKA for emergency medicine trainees. 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. From the Department of Anesthesiology, Pennsylvania State University College of Medicine, Hershey, PA. Dr. Murray is on the Speakers Bureau of METI, Sarasota, FL. Given 6 to 8 back-to-back sessions, it is critical that every session starts and ends on time! In an animated lecture, its important that the student group have an instructor so they can ask direct questions. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. JEMS. Make sure tore-assessthe patient after anyintervention. endobj Clearly communicate how often would you like the patients observations relayed to you by other staff members. 2009;13:505511. A hyperglycemic patient may present with tachypnea, which often presents as Kussmauls respirations, tachycardia, orthostatic blood pressure changes and other signs of dehydration and diabetic ketoacidosis (DKA). Prehosp Emerg Care. This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. Review the patients drug chart for medications which may cause a reduced level of consciousness (e.g. SimMan offers you the ability to provide simulation education to challenge and test your students clinical and decision-making skills during realistic patient care scenarios. insulin-dependent type 2 diabetes) Symptoms Typical symptoms of DKA include: Palpitations Nausea Vomiting Sweating Thirst Weight loss Leg cramps Clinical signs Typical clinical signs of DKA include: Tachycardia Hypotension Discuss the patients current clinical condition with aseniorclinicianusing anSBARR style handover. Facebook: http://www.facebook.com/geekymedics angioedema, rash) commence appropriate treatment as discussed in ouranaphylaxis guide. The students are in their first year. 2 The evaluation of potassium deficits is complicated by potassium exit from . The use of case-based simulation, although more complicated and time consuming for the instructor, immerses the students in the subject matter. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. vD0 x@FFJ{m[ 3//Oh|JR7! A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Nandate, Koichiro MD, PhD; Abola, Ramon MD; Murray, W Bosseau MB; Whitfield, Carol PhD; Lang, Charles PhD; Sinz, Elizabeth MD. Its important to train and educate students of prehospital care on key indicators of a diabetic emergency. Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. 1) Please read through this document as it will help you prepare for your upcoming simulation on DKA. Schneider Sarver PA, Senczakowicz EA, Slovensky BM. The 60 minutes training time consists of four 15-minute sections divided as follows. - Introduction 00:00 The debriefing environment should be removed from the location where the simulation took place. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. <>>> 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). An oxygen mask is also demonstrated as an alternative device, as these early trainees had mostly not yet seen any of these devices. Case-based education adds a real-world aspect to the learning environment. . Instructors should write a case study for the simulation before the session. The students are in their basic science course. - Exacerbating & relieving factors 05:12 The main goal is to establish a safe learning environment for the learner [9, 13 . 3. Does the patient need reviewing by a specialist? Your message has been successfully sent to your colleague. DKA can be caused by either: Absolute insulin deficiency (e.g. <> Abdomen: The abdominal examination reveals diffuse mild epigastric tenderness to deep palpitation but neither rebound tenderness nor guarding (result of examination given by patient or by instructor). A well-staged environment allows for greater student buy-in. TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. She is lethargic and slightly confused but can intermittently respond to questions. insulin-dependent type 2 diabetes), Altered consciousness (e.g. We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. Insert the airway bevel-end first, vertically along the floor of the nose with a slight twisting action. Introduceyourselfto thepatientincluding yournameandrole. The file explaining the session is sent to instructors 1 week before the sessions. You may be trying to access this site from a secured browser on the server. Are any further assessments or interventions required? Trainee will recognize the need for therapy and suggest an appropriate therapy in a simulated environment. - Examples 05:45 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. type 1 diabetes) Complete insulin insensitivity (e.g. Below is a collection of donated scenarios for you to use or modify. Refer to your local guidelines which should provide a clear protocol for the management of DKA. - Severity 05:32 (1) The assessment of a diabetic patient is best taught as a. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better.