- Respiratory Therapy
Pt has 1 week history of cough/fever, seen in ED yesterday and intubated this morning for worsening SOB and hypoxia. Remains difficult to oxygenate. Hypotensive and on pressure support. Pt taken to CT scan then directly to ICU. More difficult to bag en-route to ICU.
Pt O2 sat decreasing to 82%- 75%. Pt develops decreased breath sounds to left lung – no air entry.
Pt develops tension pneumothorax. Trach deviation to right.
Pt deteriorates to PEA arrest.
- Manikin (high sophistication)
Tested once/used once and feedback from staff examined. No significant changes made to scenario.
Knowledge & Skills:
- Rapidly recognize deterioration in patient status
- Assist physician with insertion of chest tube – equipment, dressing, pleurevac set-up
- Recognize PEA and follow PEA ACLS algorithm
Attitudes and Judgement:
- Demonstrate role clarity, delegation of roles and responsibilities early in scenario
- Demonstrate effective communication during the scenario: constructing clear messages, closed loop communication, sharing mental model
- Exhibit elements of good teamwork
- Demonstrate effective resource utilization
- Exhibit situational awareness/ global awareness – recognizing limitations, avoiding fixation error