dka 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. It may be necessary toexposethe patient during your assessment: remember to prioritise patient dignity and conservation of body heat. cellulitis). 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). TikTok: https://www.tiktok.com/@geekymedics Review the patientscurrent medicationsand check any regular medications areprescribed appropriately. (1) The assessment of a diabetic patient is best taught as a. Data is temporarily unavailable. Because of this consciousness status, it is very difficult to obtain information of cardiovascular, pulmonary, renal, hepatic, endocrine, hematology, or coagulation status other than uncontrolled diabetes. Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most common in patients with type 1 diabetes in particular due to a deficiency or absence of insulin [1].. The students are in their first year. Terms of Use. The students have acquired all the applicable theoretical knowledge of the case during the previous multiday PBL sessions. Please enable scripts and reload this page. Section snippets . . Scenario in a Nutshell Diabetic ketoacidosis (DKA) in pregnancy. DO NOT perform any examination or procedure on patients based purely on the content of these videos. 2. 2. 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). 4. The instructors never expect the trainees to exhibit full understanding of pathophysiology and skills in the treatment but do give them a few important points to understand the diagnosis and initial treatment of the patients with DKA. PA EMT Said COVID Patient Didnt Need to Go to the NYC Unions Demand Reinstatement, Back Pay for Workers Fired for Refusing President Biden to End COVID-19 Emergencies on May 11. The Theory The file explaining the session is sent to instructors 1 week before the sessions. 2 0 obj She began experiencing progressively worsening thirst, increased appetite, and excessively increased urination. - Geeky Medics OSCE App: https://geekymedics.com/geeky-medics-app/ Weight, Height: Not given, normal appearing (as per simulator) but has lost 20 lbs recently. Trainee will be respectful to others and their views during the PBL session. Review thepatients notes,chartsandrecent investigation results. Facilitator to ask how often to measure BMs Development of simulation scenarios for an adolescent patient with diabetic ketoacidosis. 2007. By joining Cureus, you agree to our We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department | Children's Hospital of Philadelphia Please write a single word answer in lowercase (this is an anti-spam measure). - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ Join the Geeky Medics community: Observe and discuss the effects of therapy in a mathematically modeled physiological simulator. 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. Trainee will be able to apply skills of communication with the simulated patient in a semiacute crisis to get sufficient important information for a final diagnosis. 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. A number of key modifiers are described that allow for the adjustment of case . See Table 4 for a suggested standardized script. In keeping with the case study, as a treatment marker is reached, the instructor should place emphasis on physiological, pharmacological, environmental and psychosocial issues. Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario Ask for anotherclinicalmemberofstafftoassistyou if possible. Each performance measure is separated into cognitive, behavioral or technical categories. 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. In this section, we have to help the trainee to institute definitive therapy based on the underlying biochemical abnormalities. The learning environment should closely mimic real-world applications. 1. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better. 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. This guide has been created to assist students in preparing for emergencysimulationsessionsas part of their training,it is not intended to be relied upon for patient care. type 1 diabetes), Complete insulin insensitivity (e.g. 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. Int J Evid Based Healthc. Published August 2015. Are any further assessments or interventions required? Assess the patients pulse and blood pressure: Inspect the patient from the end of the bed: they may appear drowsy, confused and/or clammy/pale. Ketones show 5.5. Medical simulation technology is a powerful tool for training physicians but papers dealing with DKA simulators are scarce. Insert the airway bevel-end first, vertically along the floor of the nose with a slight twisting action. 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. 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 Conclusion: Our DKA simulator is a new tool whose objective is the training in a severe, frequent and complex situation, and can be used to improve the approach made by the junior physicians to the real diabetic . }HyEf,#$/JSRU9+CF6k\'/z+i`[ 5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! Performing an ECG should not delay the emergency management of DKA. In an animated lecture, its important that the student group have an instructor so they can ask direct questions. This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. A collection of surgery revision notes covering key surgical topics. Use washable, non-toxic paints to imitate various body emissions. 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. Immersive simulations are mentally exhausting because they create an intense and stressful atmosphere requiring the learner to work outside their comfort zone. Some error has occurred while processing your request. The instructors role is to facilitate active learning through a combination of learning styles. Revisit history taking to explore relevant medical history and identify any precipitating factors for DKA. 2 The evaluation of potassium deficits is complicated by potassium exit from . Lets discuss your options. Well done, youve now stabilised the patient and theyre doing much better. - Radiation 02:45 DOWNLOAD Diabetic Ketoacidosis By the end of this scenario, the learner will be able to: 1. Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. Generaltipsfor applying anABCDEapproachin an emergency setting include: Acute scenarios typically begin with abriefhandoverfrom a member of thenursing staffincluding thepatients name,age,backgroundand thereasonthereviewhas been requested. KDCA, Ronald Reagan Washington National Airport, DC. - Introduction 00:00 Trainee will improve their understanding of clinical practice through reflective assessment of actual cases during the prior PBL sessions. This may produce better retention of the subject matter and help students adapt to emergency scenes before going into the field. The 60 minutes training time consists of four 15-minute sections divided as follows. The student group should be encouraged to collaborate on management options and to perform skills. unilateral coarse crackles may be present if the patient has pneumonia which may have been the precipitant for DKA). You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. If the provider starts an IV and gives dextrose, then the patients alertness will increase, respirations will normalize and repeated blood glucose will read 210 mg/dL over a two-minute interval. Blood sugar issues in the Type II diabetic will have a gradual onset, with diagnosis generally resulting from routine laboratory exams.(1). Insert at least onewide-bore intravenous cannula(14G or 16G) and take blood tests as discussed below. If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. Given 6 to 8 back-to-back sessions, it is critical that every session starts and ends on time! Classroom Dynamics The use of simulation-based instruction enables a student to learn at their own pace and allows them to repeat sequential steps to gain confidence and proficiency. and Glycosuria leads to urinary losses of potassium through osmotic diuresis. Trainee will increase knowledge of professional behaviors during the simulation. Perform urinalysis and send the urine for culture if urinary tract infection is suspected. Prehosp Emerg Care. Using your thumbs, slightly open the mouth by downward displacement of the chin. The facilitator guides the group only when necessary. to maintaining your privacy and will not share your personal information without Evenly balancing performance measures will ensure the student has the opportunity to critically think through patient treatment and to practice new or support previously learned behaviors and technical skills.