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Nursing Workforce Readiness: Refractory Hypoxemia in the ICU

SimX

A 52-year-old male, Michael Johnson, with a history of hypertension and type 2 diabetes, is intubated and mechanically ventilated in the ICU for progressive shortness of breath following severe pneumonia. The patient is sedated and on assist-control ventilation, but despite initial settings, the patient’s condition worsens, with the patient hypotensive...

Medical/Surgical

A 52-year-old male, Michael Johnson, with a history of hypertension and type 2 diabetes, is intubated and mechanically ventilated in the ICU for progressive shortness...

Case Information:
Bundles:
Learner Population: Nursing
Specialty: Medical/Surgical
Author: SimX
Language: English
Room size: 16x16
Setting: ICU
Patient ect:
Patient Gender: Male
Tags: Acute Respiratory Distress Syndrome, ards, hypoxemia, icu, mechanical ventilation, Nursing, patient assessment, PEEP, pneumonia, prioritization, Prone Positioning, respiratory distress, Respiratory Therapy, team communication, Vasopressors,

Nursing Workforce Readiness: Postoperative Complications

SimX

In this scenario, learners manage the post-operative transition of 52-year-old Carly Styles following a T6-T8 posterior spinal fusion. The case begins with routine post-surgical care, focusing on neurovascular assessment and Patient-Controlled Analgesia (PCA) education. While caring for the patient, a post-operative complication becomes apparent and the learners must manage the...

Medical/Surgical

In this scenario, learners manage the post-operative transition of 52-year-old Carly Styles following a T6-T8 posterior spinal fusion. The case begins with routine post-surgical care,...

Case Information:
Bundles:
Learner Population: Nursing
Specialty: Medical/Surgical
Author: SimX
Language: English
Room size: 12x12
Setting: MedSurg
Patient ect:
Patient Gender: Female
Tags: chest tube, pca, pleurovac, pneumothorax, postoperative care, respiratory distress, spinal fusion, surgical complications, surgical nursing,

Sudden Onset Respiratory Distress

Children's National

A 16-year-old with Duchenne Muscular Dystrophy with tachycardia, tachypnea and hypoxemia, found to have a pulmonary embolism, which proceeds to cardiac arrest.

Emergency Medicine

A 16-year-old with Duchenne Muscular Dystrophy with tachycardia, tachypnea and hypoxemia, found to have a pulmonary embolism, which proceeds to cardiac arrest.

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Emergency Medicine
Author: Children's National
Language: English
Room size: 12x12
Setting: PICU
Patient ect:
Patient Gender: Male
Tags: cardiac arrest, Critical Care, Duchenne Muscular Dystrophy, healthcare education, intubation, medical emergency, medical training, PE, pulmonary embolism, respiratory distress, resuscitation,

EMS Anaphylaxis with Difficult Airway

VALOR Program

Learner will arrive on-scene to find a 53-year-old female patient lying on the floor next to a dining table experiencing significant respiratory distress. A family member says the patient was eating take-out food and suddenly had difficulty breathing. The patient has a known severe peanut allergy. Learner will perform an...

Airway and Respiration

EMS Anaphylaxis with Difficult Airway

EMS Bundle

Learner will arrive on-scene to find a 53-year-old female patient lying on the floor next to a dining table experiencing significant respiratory distress. A family...

Case Information:
Bundles: EMS Bundle
Learner Population: EMS/Prehospital
Specialty: Airway and Respiration
Author: VALOR Program
Language: English
Room size: 10x10
Setting: Ambulance, Home
Patient ect:
Patient Gender: Female
Tags: Adult, AEMT, als, anaphylaxis, bls, Distributive shock, EMT, Military, Paramedic, prehospital, respiratory distress,

Alcohol Withdrawal, CIWA

Houston VA

Molly Maple is a 52 year old who came through the ER. She was found at home by family passed out. The family reports she drinks heavily and thinks she passed out drunk. She came to the ER alert and oriented x 3. She is ambulatory but stumbles occasionally. She...

Medical/Surgical

Molly Maple is a 52 year old who came through the ER. She was found at home by family passed out. The family reports she...

Case Information:
Bundles:
Learner Population: Nursing
Specialty: Medical/Surgical
Author: Houston VA
Language: English
Room size: 12x12
Setting: MedSurg
Patient ect:
Patient Gender: Female
Tags: Airway, asthma, Croup, De-escalation, pals, respiratory distress,

PALS Assessment And Resuscitation

Sacramento VAMC

A six-year-old boy presents to a community ED BIBA with mom in acute distress. Learners must use their PALS training to perform an initial, primary, and secondary assessment and effectively manage the patient’s clinical condition. This case has two different clinical presentations for the learner to address appropriately. The moderator...

Emergency Medicine

A six-year-old boy presents to a community ED BIBA with mom in acute distress. Learners must use their PALS training to perform an initial, primary,...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Emergency Medicine
Author: Sacramento VAMC
Language: English
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: Airway, asthma, Croup, pals, respiratory distress,

Coarctation of the Aorta

Children's National

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 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...

Cardiology

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Cardiology
Author: Children's National
Language: English
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Female
Tags: CXR, ED, icu, pediatrics, PGE, respiratory distress,

Tracheostomy Complications—Displacement (Fresh Total Laryngectomy)

NYU Grossman School of Medicine

The patient in this scenario is a 65-year-old man with a 120-pack-year smoking history who has been in the surgical intensive care unit (SICU) for 24 hours. He had a total laryngectomy performed one day prior for laryngeal carcinoma. He required mechanical ventilatory support immediately postoperatively via a #8 cuffed...

Critical Care

The patient in this scenario is a 65-year-old man with a 120-pack-year smoking history who has been in the surgical intensive care unit (SICU) for...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Critical Care
Author: NYU Grossman School of Medicine
Language: English
Room size: 17x15
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: hypoxia, icu, laryngeal carcinoma, laryngectomy, laryngectomy stoma, postoperative, respiratory distress, SICU, tracheostomy,

Pediatric Asthma Exacerbation

Southeastern Illinois College

The patient is a fifteen-year-old teenage male that presents to the medical clinic with asthma exacerbation. He is attended by his parent. The patient reports having played a football game earlier this week in cold, damp weather. He has a two-day history of a non-productive cough, shortness of breath, and...

Pediatric

The patient is a fifteen-year-old teenage male that presents to the medical clinic with asthma exacerbation. He is attended by his parent. The patient reports...

Case Information:
Bundles:
Learner Population: Nursing
Specialty: Pediatric
Author: Southeastern Illinois College
Language: English
Room size: 16x16
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: asthma, asthma exacerbation, cough, pediatric asthma, respiratory distress, sbar, shortness of breath, therapeutic communication,

Severe Trauma

Sun City Simulation

In this scenario, EMS arrives with a patient involved in a motor vehicle crash. EMS delivers the patient with a 20 gauge IV in the left arm, having placed them in an extrication C-collar, and initiated a simple mask for oxygen delivery. The patient is moved from a resuscitation room...

Trauma

In this scenario, EMS arrives with a patient involved in a motor vehicle crash. EMS delivers the patient with a 20 gauge IV in the...

Case Information:
Bundles:
Learner Population: Interprofessional
Specialty: Trauma
Author: Sun City Simulation
Language: English
Room size: 20x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: allergic reaction, allergy, ampicillin, anaphylaxis, deescalation, drug reaction, dyspnea, epinephrine, hives, medication reaction, penicillin, rash, respiratory distress, shortness of breath, urticaria, wheezing,

Geriatric Pneumonia—Inpatient

University of Nebraska Medical Center

A 68-year-old male with COPD is admitted to the hospital with pneumonia; the signout says he became more sick overnight. The learner must identify that the patient is in respiratory distress and begin interventions to treat him, including administering oxygen via nasal cannula or non-rebreather. The learner is expected to...

Medical/Surgical

Geriatric Pneumonia—Inpatient

SimX Nursing Bundle

A 68-year-old male with COPD is admitted to the hospital with pneumonia; the signout says he became more sick overnight. The learner must identify that...

Case Information:
Bundles: SimX Nursing Bundle
Learner Population: Nursing
Specialty: Medical/Surgical
Author: University of Nebraska Medical Center
Language: English
Room size: 15x15
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: altered mental status, arterial blood gas, copd, delirium, infection, pneumonia, respiratory distress, shortness of breath, wheezing,

Goals of Care Discussion

Maimonides Medical Center

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, 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...

Palliative Medicine/Hospice

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,...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Palliative Medicine/Hospice
Author: Maimonides Medical Center
Language: English
Room size: 17x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: communication, geriatrics, goals of care, palliative care, respiratory distress, shortness of breath,

Infant with Bronchiolitis

Queensland Health Service

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 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,...

Emergency Medicine

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...

Case Information:
Bundles:
Learner Population: Interprofessional
Specialty: Emergency Medicine
Author: Queensland Health Service
Language: English
Room size: 15x15
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: airway emergencies, bronchiolitis, pals, pediatrics, respiratory distress, shortness of breath,

Intubation of Pediatric Patient with Suspected COVID

Children's National

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 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...

Emergency Medicine

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Emergency Medicine
Author: Children's National
Language: English
Room size: 18x14
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: congenital heart disease, covid, intubation, pediatric covid, pediatric intubation, pediatric respiratory distress, ppe, respiratory distress, respiratory failure,