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Scenario:

Respiratory failure in a patient with coronavirus

Contributed by: Tim Willett
Posted on: April 01, 2020
Last Updated on: April 01, 2020
Language: English

Peer Reviewed

April 01, 2020

Brief Summary:
A 47 year old male presents with acute respiratory failure via EMS. He rapidly decompensates upon arrival. His travel history is missed on initial screening by EMS due his severity so he is transferred to the trauma bay without appropriate precautions. Part-way through the case his travel history is revealed (if not already asked for) and the team must appropriately don /doff PPE and build a plan for safe intubation.
Healthcare Field(s): Emergency / trauma
Simulation Modality(ies): Manikin (high sophistication), Manikin (mid/low sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing, Practical Nursing
Number of Learners: 1 - 8
Target Learners: Level(s): Continuing professional development
Scenario:

COVID-19 Scenario & Guide for Hospital Preparedness

Contributed by: Tim Willett
Posted on: March 12, 2020
Last Updated on: April 02, 2020
Language: English

Peer Reviewed

April 02, 2020

Brief Summary:
Scenario: Case designed during the January 2020 COVID-19 outbreak in order to assess and improve team preparedness for safely and effectively caring for a critically ill coronavirus patient from triage through to intubation and disposition in a community hospital. The scenario focusses on system processes more than individual skills. This case was adapted from one published on EM Sim Cases by Dr. Alia Dharamsi, Dr. SooJin Yi, and Dr. Kate Hayman from the University of Toronto. Guide: A brief guide to planning your own in-situ simulation for COVID preparedness based on lessons learned at the Kelowna General Hospital.
Healthcare Field(s): Critical care, Emergency / trauma, Mass casualty & triage / chemical/biological/radiological/nuclear / emergency planning
Simulation Modality(ies): Manikin (high sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medical Laboratory Science, Medical Radiation Technology, Medicine, Nursing, Other, Paramedicine, Pharmacy, Physician Assistant, Practical Nursing, Respiratory Therapy, Speech-Language Pathology
Number of Learners: 2 - 10
Target Learners: Level(s): Graduate / postgraduate / residency, Continuing professional development
Assessment tool:

PEARLS for Systems Integration Debriefing Tool

Contributed by: Mirette Dube
Posted on: June 13, 2019
Last Updated on: June 17, 2019
Language: English

Peer Reviewed

June 13, 2019

Brief Summary:
The PEARLS for Systems Integration Debreifng Tool is now available as a free colour download.  
Healthcare Field(s): Anesthesia / peri-anesthesia care, Critical care, Emergency / trauma, Pre-hospital / paramedic, Mass casualty & triage / chemical/biological/radiological/nuclear / emergency planning, Medical, Gerontology / geriatrics / aging, Obstetrics & maternal-child, Reproductive & gynecology, Mental health & psychiatry, Neonatal, Palliative & end-of-life care, Pathology and laboratory, Pediatrics / child & family, Primary care / community care / family practice, Public health & health promotion, Radiology & diagnostic imaging, Rehabilitation & restorative care, Surgical
Simulation Modality(ies): Hybrids or blended simulation, Manikin (high sophistication), Manikin (mid/low sophistication), Procedural simulations, Standardized/simulated patients or real patients
Interprofessional: No
Intended for: No
Profession(s): Acupuncture, Audiology, Chiropody or Podiatry, Chiropractic, Dental Hygiene, Dental Technology, Dentistry, Denturism, Developmental Services Work, Dietitics, Firefighting, Homeopathy, Kinesiology, Massage Therapy, Medical Laboratory Science, Medical Radiation Technology, Medicine, Midwifery, Naturopathy, Nursing, Occupational Therapy, Opticianry, Optometry, Other, Paramedicine, Personal Support Worker, Pharmacy, Physician Assistant, Physiotherapy, Podiatry, Police or Law Enforcement, Practical Nursing, Psychology, Psychotherapy or Mental Health Therapy, Recreation Therapy, Respiratory Therapy, Social Work, Speech-Language Pathology, Traditional Chinese Medicine, Veterinary Medicine
Number of Learners: -
Target Learners: Level(s): Graduate / postgraduate / residency, Continuing professional development
Scenario:

ARDS / Pneumothorax

Contributed by: Karen Schafer
Posted on: July 04, 2016
Last Updated on: July 04, 2016
Language: English

Peer Reviewed

July 04, 2016

Brief Summary:
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.
Healthcare Field(s): Critical care
Simulation Modality(ies): Manikin (high sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing, Respiratory Therapy
Number of Learners: 3 - 8
Target Learners: Level(s): Graduate / postgraduate / residency, Continuing professional development
Scenario:

Anaphylaxis - Adult

Contributed by: Karen Schafer
Posted on: June 30, 2016
Last Updated on: June 30, 2016
Language: English

Peer Reviewed

June 28, 2016

Brief Summary:
Mike is a 35 year old male. He was on a first date at Nami sushi on Lonsdale. His date offered him gomae, he took one bite and felt lip tingling immediately, he told his date about his severe peanut allergy and they came to the ED. No Epi Pen.            Triage nurse to present case to Emerg Nurse. Additional info: Pt is now drooling with a hoarse voice and notable lip swelling.             Pt’s status deteriorates (over approximately 5 minutes)            Pt continues to decline, unable to verbalise, airway occluded, resp distress             Pt improves with cricothyrotomy
Healthcare Field(s): Emergency / trauma
Simulation Modality(ies): Manikin (high sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing, Respiratory Therapy, Social Work
Number of Learners: 3 - 6
Target Learners: Level(s): Graduate / postgraduate / residency, Continuing professional development
Scenario:

PediatricSeizure

Contributed by: Karen Schafer
Posted on: June 30, 2016
Last Updated on: June 30, 2016
Language: English

Peer Reviewed

June 28, 2016

Brief Summary:
7 year old child, febrile for 2 days, parents notice seizure like activity and bring to emergency. During initial assement, patient seizes. Patient stops seizing when given appropriate mediations.
Healthcare Field(s): Emergency / trauma, Pediatrics / child & family
Simulation Modality(ies): Manikin (high sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing, Respiratory Therapy, Social Work
Number of Learners: 3 - 6
Target Learners: Level(s): Graduate / postgraduate / residency, Continuing professional development
Scenario:

EMR-sim

Contributed by: Aviv Shachak, Ph.D., University of Toronto
Posted on: February 02, 2018
Last Updated on: February 02, 2018
Language: English

Peer Reviewed

June 01, 2016

Brief Summary:
EMR-sim is a computer-based (‘virtual patient’) simulation to teach clinicians on the challenges of using electronic medical records (EMRs) in the patient-clinician encounter. The scenarios for this project were designed on the basis of a literature review and a research study of the impact of EMRs on the clinical encounter and the strategies and best practices developed by clinicians to overcome the negative impacts and maximize the benefits of using the EMR. The simulation was pilot tested with Family Medicine residents at Sunnybrook Health Sciences Centre in Toronto with promising results. The project was funded by SIM-one Research and Innovation grant. Two prototype virtual patient cases are shared under Creative Commons (attribution- non-for-profit- share alike) license.  
Healthcare Field(s): Primary care / community care / family practice
Simulation Modality(ies): Virtual patients
Interprofessional: No
Intended for: No
Profession(s): Medicine, Nursing
Number of Learners: 1 - 1
Target Learners: Level(s): Undergraduate / post-secondary, Graduate / postgraduate / residency, Continuing professional development
Scenario:

Difficult Intubation - ICU

Contributed by: Karen Schafer
Posted on: April 21, 2016
Last Updated on: April 21, 2016
Language: English

Peer Reviewed

April 19, 2016

Brief Summary:
This scenario uses a physician confederate, who becomes fixated on intubation while the patient deteriorates, and offers the nursing and RT staff an opportunity to recognize and manage a critical deterioration as well as a fixation error.
Healthcare Field(s): Critical care
Simulation Modality(ies):
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing, Respiratory Therapy
Number of Learners: 4 - 7
Target Learners: Level(s): Continuing professional development
Assessment tool:

Situation awareness assessment in patient deterioration simulations

Contributed by: Patrick Lavoie, RN, PhD (c), Université de Montréal
Posted on: March 04, 2016
Last Updated on: March 04, 2016
Language: English

Peer Reviewed

March 04, 2016

Brief Summary:
This is an instrument to measure situation awareness in nurses participating in a patient deterioration simulation scenario. It measures nurses' perception of quantifiable signs of deterioration (e.g., vital signs, level of consciousness) and less quantifiable signs of deterioration (e.g., breath sounds, agitation, new pain). It also measures nurses' comprehension of the meaning of these signs and their projection of their status in the near future. The instrument has been used to operationalize the concept of clinical judgment in a RCT (publication under review).
Healthcare Field(s): Critical care, Medical, Surgical
Simulation Modality(ies): Manikin (high sophistication), Manikin (mid/low sophistication), Role-playing, Standardized/simulated patients or real patients
Interprofessional: No
Intended for: No
Profession(s): Nursing
Number of Learners: -
Target Learners: Level(s): Undergraduate / post-secondary, Continuing professional development
Scenario:

Cardiac Arrest due to Blocked Airway

Contributed by: Karen Schafer
Posted on: February 18, 2016
Last Updated on: February 18, 2016
Language: English

Peer Reviewed

January 29, 2016

Brief Summary:
Elderly man in ICU 12 hours post cardiac arrest.  ETT blocks leading to cardiac deterioration.
Healthcare Field(s): Critical care
Simulation Modality(ies): Manikin (high sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Nursing, Respiratory Therapy
Number of Learners: 3 - 5
Target Learners: Level(s): Continuing professional development

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