STEMI V-Fib Arrest
Ohio State UniversityA patient presents to the ED with sudden chest heaviness that is radiating to their jaw. The patient also reports anxiety, diaphoresis, and nausea. The case starts off with an EMS handoff. Their symptoms are progressively worsening since first appearing one hour before; upon arrival at the ED, they are...
A patient presents to the ED with sudden chest heaviness that is radiating to their jaw. The patient also reports anxiety, diaphoresis, and nausea. The...
Tracheostomy Complications—Cuff Leak
NYU Grossman School of MedicineIn this scenario, the learner is called to the bedside of a 65-year-old man by a MICU nurse due to hypoxia and low pressure alarm on the ventilator. The patient has a prolonged recovery from ARDS and requires a continual mechanical ventilatory support. He also underwent percutaneous tracheostomy insertion 10...
In this scenario, the learner is called to the bedside of a 65-year-old man by a MICU nurse due to hypoxia and low pressure alarm...
Sepsis Care
University of Nebraska Medical CenterThe patient is an 84-year-old female who is in the hospital after a bowel surgery. The learner receives a handoff from the previous nurse and should recognize signs that the patient is sick. The learner must perform an assessment where they will find fever, tachycardia, decreased urine output, abdominal pain,...
Sepsis Care
The patient is an 84-year-old female who is in the hospital after a bowel surgery. The learner receives a handoff from the previous nurse and...
Outpatient Preeclampsia
University of Nebraska Medical CenterA 24-year-old woman who is 31 weeks pregnant presents for an OB visit feeling fatigued. The learner performs an initial assessment identifying the signs and symptoms of preeclampsia including hypertension, weight gain, and proteinuria on urinalysis. After discussing with the physician, the patient is admitted to the hospital where the...
A 24-year-old woman who is 31 weeks pregnant presents for an OB visit feeling fatigued. The learner performs an initial assessment identifying the signs and...
Goals of Care Discussion
Maimonides Medical CenterIn 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,...
Brief Psychotic Disorders
Indiana University School of NursingSam is a 45-year-old caucasian female who was brought to the ER by her brother. Her brother reported that Sam was acting strange over the past couple of weeks; in particular, he noticed poor hygiene, bizarre behaviors, and interrupted sleep patterns. He also believes she has auditory and visual hallucinations....
Brief Psychotic Disorders
Sam is a 45-year-old caucasian female who was brought to the ER by her brother. Her brother reported that Sam was acting strange over the...
Epileptic Seizure
Inselspital - Universitätsspital BernA patient presents to the emergency department with a severe right sided headache that began acutely two hours prior. The learner must perform an initial assessment during which the patient will show worsening confusion and, eventually, will have a generalized tonic-clonic seizure. The learner must treat the seizure with benzodiazepines,...
A patient presents to the emergency department with a severe right sided headache that began acutely two hours prior. The learner must perform an initial...
Chest Pain—ACS
Queensland Health ServiceA 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...
Primary Postpartum Hemorrhage
Queensland Health ServiceThis 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...
Infant with Bronchiolitis
Queensland Health ServiceA 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...
Adult Seizure in EMU
Baylor College of MedicineJamie Walden is a 24-year-old female with a history of febrile seizures starting at age 2, with subsequent seizures when she was 12. She failed several AEDs and is admitted to the EMU for seizure classification as part of a presurgical workup for epilepsy surgery. The learner must perform an...
Adult Seizure in EMU
Jamie Walden is a 24-year-old female with a history of febrile seizures starting at age 2, with subsequent seizures when she was 12. She failed...
EMS 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...
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...
Teenager with 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...
Pediatric Post-op Hypoxia and 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...
Desaturation and Bradycardia in Infant
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...
Pediatric Post-op SVT
Children's NationalIn this scenario, a 4-day old baby boy 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...
In this scenario, a 4-day old baby boy is in the cardiac intensive care unit recovering from a coarctation repair. The patient is intubated with...
Pediatric 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 Pulmonary Hypertensive Crisis
Children's NationalIn this scenario, the patient is a 3-day-old male with a history of obstructed supracardiac TAPVR. He progressively develops a pulmonary hypertensive crisis with decreasing oxygen saturation, elevated heart rate, and decreasing blood pressure. The learner must recognize that the patient is at high risk for a pulmonary hypertensive crisis...
In this scenario, the patient is a 3-day-old male with a history of obstructed supracardiac TAPVR. He progressively develops a pulmonary hypertensive crisis with decreasing...
Intubation of Pediatric Patient with Suspected COVID
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...