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Scenario:

Acute Stroke on the Ward

Contributed by: ALIM NAGJI, MD CCFP-EM DRCPSC (Clin.Ed.), Joseph Brant Hospital
Posted on: May 13, 2021
Last Updated on: May 13, 2021
Language: English

Peer Reviewed

January 01, 2021

Brief Summary:
A 74 year old female is admitted under the hospitalist at a community hospital with a UTI. She is on day 3 of antibiotic therapy. While in hospital, she develops acute onset of right arm weakness, facial droop and unintelligible speech. Participants should recognize an acute CVA within the window, perform a stroke assessment, treat hypertension and administer TPA and consider thrombectomy.   This case can be performed by hospitalists, internists, intensivists or in situations where ED doctors are called to the floor. The time of day can also be modified to after hours to emphasize how local protocols may differ at various points of the day. In this case, no in hospital neurologist is available and the hospital is not a stroke centre. 
Healthcare Field(s): Critical care, Emergency / trauma, Medical
Simulation Modality(ies): Manikin (mid/low sophistication), Role-playing
Interprofessional: No
Intended for: No
Profession(s): Medicine
Number of Learners: 1 - 3
Target Learners: Level(s): Undergraduate / post-secondary, Graduate / postgraduate / residency, Continuing professional development
Scenario:

Essential COVID-19 Skills Training for Health Care Workers

Contributed by: Tim Willett
Posted on: December 22, 2020
Last Updated on: February 17, 2021
Language: English

Peer Reviewed

December 22, 2020

Brief Summary:
The Canadian Association of Schools of Nursing (CASN) in partnership with the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) have collaborated to develop and disseminate five virtual simulation modules in both official languages to build capacity among graduating and new registered nurses entering the health care workforce during the COVID-19 pandemic. VSGs have been developed in the following areas: Care of patient on ventilation Multiple organ dysfunction Geriatric fluid volume deficiency Deteriorating patient Running a code ACCESS THE VSGs >
Healthcare Field(s): Critical care, Emergency / trauma, Medical, Gerontology / geriatrics / aging
Simulation Modality(ies): Virtual patients
Interprofessional: No
Intended for: No
Profession(s): Nursing, Practical Nursing
Number of Learners: 1 - 500
Target Learners: Level(s): Undergraduate / post-secondary, Graduate / postgraduate / residency, Continuing professional development
Scenario:

Opioid Overdose

Contributed by: ALIM NAGJI, MD CCFP-EM DRCPSC (Clin.Ed.), Joseph Brant Hospital
Posted on: May 13, 2021
Last Updated on: May 13, 2021
Language: English

Peer Reviewed

August 24, 2020

Brief Summary:
The team is called to manage an unresponsive man with respiratory depression. The initial assessment involves rapidly evaluating potential causes for altered mental status, including hypoglycemia, hypoxia, and intoxication. Initial management of hypoglycemia and airway support does not improve the patient’s mental status. The team must recognize opioid toxidrome and administer naloxone. The patient will require multiple doses of naloxone to achieve adequate response. He will emerge in precipitated withdrawal, and try to leave AMA. The team will discuss disposition for this patient.
Healthcare Field(s): Emergency / trauma
Simulation Modality(ies): Manikin (high sophistication), Manikin (mid/low sophistication), Standardized/simulated patients or real patients
Interprofessional: No
Intended for: No
Profession(s): Medicine
Number of Learners: 1 - 3
Target Learners: Level(s): Undergraduate / post-secondary, Graduate / postgraduate / residency, Continuing professional development
Scenario:

Cardiovascular shock in the infant (from Coarctation of the Aorta)

Contributed by: ALIM NAGJI, MD CCFP-EM DRCPSC (Clin.Ed.), Joseph Brant Hospital
Posted on: May 13, 2021
Last Updated on: May 13, 2021
Language: English

Peer Reviewed

August 24, 2020

Brief Summary:
A 10-day-old term male neonate is brought to the emergency department by his parents. Their concerns are that, over the course of the day, he has become pale, his feet look “bluer”, and he is more lethargic. Moreover, he has only made 1 diaper today and is feeding very poorly. On examination, this is a very sick child presenting with tachycardia, tachypnea, peripheral cyanosis, weak femoral pulses, and a BP gradient (secondary to coarctation of the aorta). The child is in cardiovascular shock secondary to closure of the ductus arterosus. He needs to be given prostaglandins and oxygen, IV access, and cardiovascular and respiratory monitoring. He also needs to be referred to a pediatric cardiologist for further management and a pediatric intensivist for admission.
Healthcare Field(s): Emergency / trauma, Pediatrics / child & family
Simulation Modality(ies): Manikin (high sophistication), Manikin (mid/low sophistication)
Interprofessional: Yes
Intended for: Yes
Profession(s): Medicine, Nursing
Number of Learners: 1 - 3
Target Learners: Level(s): Undergraduate / post-secondary, Graduate / postgraduate / residency, Continuing professional development
Scenario:

Supporting Clinical Student Success - A Scenario for New Faculty

Contributed by: Sandra Nadelson, RN, MSN, MSEd, PhD, CHSE, Universitiy of Central Arkansas
Posted on: May 19, 2021
Last Updated on: May 19, 2021
Language: English

Peer Reviewed

May 19, 2021

Brief Summary:
Many faculty members feel unprepared to hold discussions and develop plans for helping students meet clinical course objectives. This scenario helps prepare faculty members to develop a plan using a positive growth mindset framework to support students to become successful professionals. The scenario is written for nursing, but could easily be used by a variety of health professionals.
Healthcare Field(s):
Simulation Modality(ies): Standardized/simulated patients or real patients
Interprofessional: No
Intended for: No
Profession(s): Dental Hygiene, Developmental Services Work, Firefighting, Kinesiology, Massage Therapy, Medical Radiation Technology, Midwifery, Nursing, Occupational Therapy, Practical Nursing, Respiratory Therapy, Social Work, Speech-Language Pathology
Number of Learners: 2 - 15
Target Learners: Level(s): Continuing professional development
Scenario:

Newborn Virtual Simulation

Contributed by: Kelly Hudder, RN, MScN, CHSE, Trent University
Posted on: May 19, 2021
Last Updated on: May 19, 2021
Language: English

Peer Reviewed

June 03, 2020

Brief Summary:
This maternal/child resource is aimed to support learning for the undergraduate nursing student in any nursing program. The simulation is intended to promote the development of clinical judgement skills through a safe learning environment. The virtual simulation is for students to practice and reflect on newborn assessments while critically analyzing the scenario and completing a clinical pathway. The serious game utilizes audio/video clips and questioning to progress and reveal a pathway. Students will be required to perform a head-to-toe assessment of a newborn, which will include heart rate as well as respiratory rate. Upon completion of the virtual simulation all learners are required to complete a debriefing activity to enhance learning and reflect in, on and beyond action.  
Healthcare Field(s): Neonatal
Simulation Modality(ies): Video-based simulation, Virtual patients
Interprofessional: No
Intended for: No
Profession(s): Nursing
Number of Learners: 1 - 1
Target Learners: Level(s): Undergraduate / post-secondary
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

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