Reduced urine output (oliguria) is typically defined as less than 0.5ml/kg/hour in an adult. The main purpose of the simulation is to draw a line from the theoretical, boring biochemistry to the clinical manifestations. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. Data is temporarily unavailable. A well-staged environment allows for greater student buy-in. Paediatric DKA | Simulation Education Insert at least onewide-bore intravenous cannula(14G or 16G) and take blood tests as discussed below. 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. We have spent many hours debating whether the small group format was a waste of time. Trainee will learn to collaborate with peers to decide on appropriate interventions, tests, and therapy. Scenarios thesimtech PBL was introduced at our institution in 1995. 4. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. PDF Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario They should introduce the student group to the environment, assign roles for each learner and guide the decision-making process. - Severity 05:32 2. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Feel the slow and tardy pulse, we consider these PBL sessions as an example of a Look here, see this use of a full human simulator in the hierarchy of learning strategies with a full human simulator (Table 1). Check out our other awesome clinical skills resources including: Refer to your local guidelines for further details. Insert the airway bevel-end first, vertically along the floor of the nose with a slight twisting action. Invasive monitors, including a left radial intraarterial and a right subclavian IV catheter, were placed. endobj Join the Geeky Medics community: Should any changes be made to the current management of their underlying condition(s)? 2009;13:505511. If any obstruction is encountered, remove the tube and try the left nostril. There are just a few more things to do. The trainees have had background knowledge of biochemistry because they had completed the PBL case. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Anesthetic Management Using the Oxygen Reserve Index for Tracheal Resection and Tracheal End-to-E A Scoping Review of the Impact of COVID-19 on Kidney Transplant Patients in the United States, Alabama College of Osteopathic Medicine Research, Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, DMIMS School of Epidemiology and Public Health, Simulation, Biodesign, & Innovation In Medical Education, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, VCOM Clinical, Biomedical, and Educational Research, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Medical Society of Delaware Academic Channel, Society for Healthcare & Research Development, Surgically Targeted Radiation Therapy for Brain Tumors: Clinical Case Review, Clinical and Economic Benefits of Autologous Epidermal Grafting, Defining Health in the Era of Value-Based Care, Optimization Strategies for Organ Donation and Utilization, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings. - Introduction 00:00 A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. The patient synopsis should include such standard aspects as age, sex, ethnicity, medical history, medications and allergies. A blood glucose level may already be available from earlier investigations (e.g. Kymera Systems Inc | SCADA Online Demo Ignition If the patientloses consciousnessand there areno signs of lifeon assessment, put out acrash callandcommence CPR. Blood sugar issues in the Type II diabetic will have a gradual onset, with diagnosis generally resulting from routine laboratory exams.(1). Subscribe to our newsletter to be the first to know about our latest content: https://geekymedics.com/newsletter/ Marx JA, Hockberger RS, Walls RM. >> Fernandez AR, Mac Crawford J, Pennell ML, et al. This leads to hyperglycaemia, osmotic diuresis, and dehydration. DIABETIC KETOACIDOSIS MODULE: ENDOCRINOLOGY / METABOLIC TARGET: ALL PAEDIATRIC TRAINEES;NURSING STAFF BACKGROUND: DKA occurs when a relative or absolute lack of insulin leads to the inability to metabolise glucose. Review the patientscurrent medicationsand check any regular medications areprescribed appropriately. Diabetes mellitus affects nearly 7.8% of the U.S. population, with approximately 510% of this group affected by Type I and 9095% by Type II.1 Diabetes is the most common type of endocrine disease and was the seventh leading underlying cause of death listed on death certificates in 2006. DKA can be caused by either: Absolute insulin deficiency (e.g. Therefore, the session is divided into four sections of 15 minutes each, so that the facilitator is constantly aware of being on time (or not), even after the first 15 minutes period. The Theory Review the patientsoxygen saturation(SpO2): Auscultate the chest to screen for evidence of respiratory pathology (e.g. There are actually two sets of educational objectives: the first set is for the theoretical PBL sessions, and the 2nd set is for the Simulation Session. Research Watch Box:Sleep, Fatigue & SafetyBy David Page, MS, NREMT-P (1) According to Centers for Disease Control and Prevention (CDC), 223,619 deaths were attributed to diabetes in 2005. If the patient has clinical signs ofanaphylaxis(e.g. The Theory . 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. Hypothermia may be present if the patient has been unconscious and exposed for some time. KDCA for FSX - Fly Away Simulation Diabetic ketoacidosis; Simulation training; Medical students. We guide the group to suggest fluid. 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. PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency The validity of the HFS-DKA scenario was verified by a certified diabetes nurse educator, a registered nurse, and a clinical nurse educator. The simulation experience serves to give substance to the theoretical words and concepts that the students encountered during the PBL sessions. Introduction: Diabetic ketoacidosis (DKA) is a life-threatening illness which classically presents with polyuria, polydipsia, and polyphagia that can rapidly progress to severe dehydration and altered mental status from cerebral edema. Similar to a ward round, where the instructor would say: Come and listen to this patient with an aortic stenosis. x]o ]?9kgq~:)?hE )R6!up}\<8||\]}Y~;xp~yQ$#4~djX&{n_m-]^K1/~/AD Hv 99evs,;8}8zwnhFxV.kf-V^? Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals, Cardiovascular History Tips - DON'T FORGET these 3 things . Review thepatients notes,chartsandrecent investigation results. Much time was wasted explaining why it did not matter. Management of diabetic ketoacidosis in adults. Therefore, we have to emphasize the importance of airway, breathing, and circulation in the very sick patient in any clinical setting. LYqC+pJ&6X4onfBT#?=R}.p8N3+Dk,P4tIgWB}-L'=8;_G >,K#.e89XnG'B~NtR In other words, they do not have clinical experience, but they have clinical knowledge. If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. Simulation Scenario. - Exacerbating & relieving factors 05:12 The learning environment should closely mimic real-world applications. If an infection is suspected, IV antibioticsshould be administered as soon as possible. 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. DO NOT perform any examination or procedure on patients based purely on the content of these videos. These are not learning objectives in this program. Review the patients drug chart for medications which may cause a reduced level of consciousness (e.g. Please write a single word answer in lowercase (this is an anti-spam measure). Healthcare Students' Psychological Well-Being in a Diabetic Ketoacidosis Simulation. DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. Before trainees arrival into the simulation area, the simulator is already preprogrammed for DKA. Depending on scenario complexity, team dynamic and treatment modalities, this simulation may take 1020 minutes. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. For diabetic assessment involving DKA, staging may include the use of a container with a small amount of acetone placed near the manikin because many students may not know what acetone smells like but will expect to smell something. Initially, we used a blood pressure cuff to generate the blood pressure values. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better. 2. PDF Diabetic Ketoacidosis in the Obstetric Population: A Simulation The students have acquired all the applicable theoretical knowledge of the case during the previous multiday PBL sessions. A pre-briefing session is conducted prior to the start of the simulation scenario. 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). Instructors should write a case study for the simulation before the session. DO NOT perform any examination or procedure on patients based purely on the content of these videos. We try to provide sufficient realism.. Yes: if the patient can talk, their airway is patent and you can move on to the assessment of breathing. Please try again soon. The instructor can also gauge the direction the debriefing session should follow or be alerted to possible problems or conflicts in treatment opinions. If the patient has COPD and a history of CO2retention you should switch to aventuri maskas soon as possible andtitrate oxygen appropriately. 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).