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ACLS Knowledge Update
Air MethodsIn this scenario, a 56-year-old male patient arrives at the emergency department with chest pain with symptomatic bradycardia and unstable vital signs. The patient will progress to unstable Vtach, Vfib arrest, and then PEA arrest throughout the case. Learners will work to provide compressions, medications, electrical therapy, and airway interventions...
In this scenario, a 56-year-old male patient arrives at the emergency department with chest pain with symptomatic bradycardia and unstable vital signs. The patient will...

BOR Bronchiolitis
Bundle of RaysA 4-month-old is admitted with RSV and bronchiolitis by their mother who is concerned her baby is deteriorating. The Learner(s) must assess the patient, recognize respiratory distress, and escalate oxygen. The patient will decompensate, which requires the learner(s) to call a code blue, support the patient’s airway, suction the airway,...
A 4-month-old is admitted with RSV and bronchiolitis by their mother who is concerned her baby is deteriorating. The Learner(s) must assess the patient, recognize...

BOR Postpartum Hemorrhage
Bundle of RaysThis scenario begins with a midwife who is in the process of delivering the patient’s baby. The learner is asked to take over patient care as the situation turns complicated and the patient begins to lose a lot of blood. The learner needs to check if the baby is okay...
This scenario begins with a midwife who is in the process of delivering the patient’s baby. The learner is asked to take over patient care...

Chest Pain
Children's NationalIn this scenario, you are called to evaluate an adolescent in the Emergency Department for severe chest/epigastric pain, headache, and emesis. The patient is a 15-year-old previously healthy male who developed fever, nasal congestion, rhinorrhea, cough, and malaise 1 week ago. He was seen by his PMD and started on...
In this scenario, you are called to evaluate an adolescent in the Emergency Department for severe chest/epigastric pain, headache, and emesis. The patient is a...

Chest Pain in the ED (Resuscitation)
SimXA patient is presented to the ED with chest pain and shortness of breath and the learner is informed of onset of CP/SOB while jogging. The learner must assess the patient's ABCs and provide initial resuscitation. They must then correctly diagnose PE. This case is successfully completed by treating the...
Chest Pain in the ED (Resuscitation)
A patient is presented to the ED with chest pain and shortness of breath and the learner is informed of onset of CP/SOB while jogging....

Chest Pain: ACS
Bundle of RaysA middle-aged male presents to the emergency department feeling unwell with chest pains and fainting. During initial evaluation of the patient, he loses consciousness and has a cardiac arrest with ventricular tachycardia, which can be seen on the monitor. The learner is expected to evaluate the patient, order and interpret...
A middle-aged male presents to the emergency department feeling unwell with chest pains and fainting. During initial evaluation of the patient, he loses consciousness and...

Climbing Accident and Rescue
Air MethodsIn this scenario, a 34 year-old male is involved in a climbing accident after a rock fall cut his rope. The flight crew has arrived prior to any other first responders. The patient has sustained multiple traumatic injuries and is hemodynamically unstable when the flight crew arrives. The learner must...
In this scenario, a 34 year-old male is involved in a climbing accident after a rock fall cut his rope. The flight crew has arrived...

Coarctation
Children's National2-week-old baby girl otherwise healthy, born at 38 weeks presenting with respiratory distress. Her parents have noted that she has been breathing faster and feeding less. She has an older brother (3-year-old who is in daycare). Symptoms have been getting worse over the last couple days. She was seen at...
2-week-old baby girl otherwise healthy, born at 38 weeks presenting with respiratory distress. Her parents have noted that she has been breathing faster and feeding...

COVID-19 Triage
SimXIn this scenario, the learner is a health care provider in a triage staging tent in the parking lot of a local hospital. The patient comes in with complaints of fever and chills as well as 1 day of coughing. The learner must put on the correct form of PPE,...
COVID-19 Triage
In this scenario, the learner is a health care provider in a triage staging tent in the parking lot of a local hospital. The patient...

Desaturation & Bradycardia
Children's NationalIn this scenario the patient is a 2-month-old ex-full-term male with a history of a small secundum ASD and moderate conoventricular septal defect. He is POD#0 from stitch closure of ASD and patch repair of the VSD. The post-op TEE shows a small residual ASD, no residual VSD, and good...
In this scenario the patient is a 2-month-old ex-full-term male with a history of a small secundum ASD and moderate conoventricular septal defect. He is...

EMS Pediatric Patient
SENAIn a car accident, a pediatric patient suffers trauma, head injury, fracture of one of his arms with deformity and bruises in thorax. He is confused with recent amnesia, but responds to orders. Two EMS must secure the area, give him first attention, and take him in their ambulance to...
In a car accident, a pediatric patient suffers trauma, head injury, fracture of one of his arms with deformity and bruises in thorax. He is...

GI Bleed
Ohio State UniversityThe patient is a caucasion male who is brought into the emergency department by EMS with generalized weakness and lightheadedness. The learners should perform a focused history and physical exam to correctly diagnose GI bleed. During the encounter, the patient will have an acute episode of hematemesis and quickly decompensate...
The patient is a caucasion male who is brought into the emergency department by EMS with generalized weakness and lightheadedness. The learners should perform a...

Goals of Care Discussion
MaimonidesIn this scenario, a daughter brings her elderly father to the hospital because of respiratory distress. The patient has a history of advanced lung cancer, appears frail and very ill, and is in the emergency department requiring BIPAP for respiratory support. The learner must take the role of the emergency...
In this scenario, a daughter brings her elderly father to the hospital because of respiratory distress. The patient has a history of advanced lung cancer,...

High-Risk OB
Air MethodsThis scenario leads learners through an encounter with a patient in active labor. As the case progresses, learners must recognize that the patient is experiencing shoulder dystocia and is in active labor/imminent delivery. Following successful delivery, the infant will require basic assessment and care, and the mother will require care...
This scenario leads learners through an encounter with a patient in active labor. As the case progresses, learners must recognize that the patient is experiencing...

Inferior STEMI
SimXA patient is being brought into the ED via ambulance with chest pains and presents initially normotensive and normocardic. The learner is expected to recognize inferior STEMI by the patient’s history, exam, and EKG. They must successfully activate the cath lab and start fluids, heparin, and pressors if needed. If...
Inferior STEMI
A patient is being brought into the ED via ambulance with chest pains and presents initially normotensive and normocardic. The learner is expected to recognize...

Intubation of Suspected COVID Patient
Children's NationalIn this scenario, a patient with a history of repaired congenital heart disease arrives at the CICU in respiratory distress. This case is progressing to respiratory failure and the patient requires immediate intubation. Learners will start outside the room and receive pre-arrival information of impending respiratory failure. The learner must...
In this scenario, a patient with a history of repaired congenital heart disease arrives at the CICU in respiratory distress. This case is progressing to...

Low Cardiac Output Syndrome
Children's NationalA 3 month-old infant s/p complete AV canal defect repair is recovering in the first postoperative night in the cardiac intensive care unit. He develops junctional ectopic tachycardia with a narrow pulse pressure and hypotension. Learners must recognize and diagnose the arrhythmia and provide therapies to improve the cardiac output...
A 3 month-old infant s/p complete AV canal defect repair is recovering in the first postoperative night in the cardiac intensive care unit. He develops...

Pediatric Airway
Air MethodsA 5-year-old male with a history of asthma presents to a small community hospital ED with three days of worsening shortness of breath that requires transfer to a pediatric capable facility. Learners must recognize severe asthma and initiate usual asthma treatment, but the child does not respond to these basic...
A 5-year-old male with a history of asthma presents to a small community hospital ED with three days of worsening shortness of breath that requires...

Post-Op SVT
Children's NationalIn this scenario, a 7-day old infant is in the cardiac intensive care unit recovering from a coarctation repair. The patient is intubated with all postoperative lines, drains, etc. and is in hemodynamically unstable supraventricular tachycardia at the beginning of the scenario. The patient has already been given adenosine twice...
In this scenario, a 7-day old infant is in the cardiac intensive care unit recovering from a coarctation repair. The patient is intubated with all...

Post-Op: Hypoxia & Hypotension
Children's NationalIn this scenario the patient is a 4 d/o male with HLHS (mitral and aortic atresia) s/p Stage 1 (Norwood) procedure presenting in a low-output state with progressive hypotension and hypoxemia. Learners must assess the patient, evaluate the situation, recognize abnormal findings, and respond with appropriate interventions.
In this scenario the patient is a 4 d/o male with HLHS (mitral and aortic atresia) s/p Stage 1 (Norwood) procedure presenting in a low-output...

Postpartum Hemorrhage in ED
VituityA 28-year-old female with no prenatal care is imminently delivering in the emergency room. The scenario begins with an EMS handover. Following the handover and subsequent placenta delivery, the patient becomes hemodynamically unstable from postpartum hemorrhage and requires aggressive resuscitation. If this is performed properly, the patient will improve, if...
A 28-year-old female with no prenatal care is imminently delivering in the emergency room. The scenario begins with an EMS handover. Following the handover and...

Precipitous Labor & Neonatal Resuscitation
SimXThis scenario starts in the emergency department. There is an obviously pregnant mom who is screaming in pain. The OB/GYN cannot arrive at the hospital in time, even if they are paged. Delivery becomes imminent, and the mom gives birth to a baby with a poor tone and low heart...
Precipitous Labor & Neonatal Resuscitation
This scenario starts in the emergency department. There is an obviously pregnant mom who is screaming in pain. The OB/GYN cannot arrive at the hospital...