Tracheostomy Complications—Occluded Inner Cannula (Fresh Tracheostomy)
NYU Grossman School of MedicineThe patient us a 65 year-old man who has been in the MICU for 14 days with acute respiratory distress syndrome (ARDS). He had a percutaneous tracheostomy performed 2 days ago and he continues to require mechanical ventilatory support. You are called to the bedside by the ICU nurse because...
The patient us a 65 year-old man who has been in the MICU for 14 days with acute respiratory distress syndrome (ARDS). He had a...
EMS Prehospital Pediatric Trauma
Servicio Nacional de Aprendizaje (SENA)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 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...
Coarctation of the Aorta
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...
Tracheostomy Complications—Displacement (Fresh Total Laryngectomy)
NYU Grossman School of MedicineThe 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...
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...
Aggressive Behavior Management for Dementia Patient
Keimyoung UniversityA 79-year-old elderly woman with dementia has been unable to adjust to the three-person room at the nursing hospital for three weeks and is showing aggressive behaviors such as screaming and swearing. She is able to communicate easily with an MMSE score of 15/30, but she is angry with her...
A 79-year-old elderly woman with dementia has been unable to adjust to the three-person room at the nursing hospital for three weeks and is showing...
BTT Shunt Occlusion in Interstage Patient with HLHS
Children's NationalThe patient is a 5-week-old baby girl with a prenatal diagnosis of hypoplastic left heart syndrome, status post-Norwood with a 3.5mm BTT shunt at DOL5. Her intraoperative and postoperative course was relatively unremarkable, and she had been in the hospital for two weeks post-op, working on feeding issues. She has...
The patient is a 5-week-old baby girl with a prenatal diagnosis of hypoplastic left heart syndrome, status post-Norwood with a 3.5mm BTT shunt at DOL5....
Tracheostomy Complications—Displacement (Fresh Tracheostomy)
NYU Grossman School of MedicineThe patient is a 65 year-old man who has been in the MICU for 14 days with acute respiratory distress syndrome (ARDS). He had a percutaneous tracheostomy performed two days ago and he continues to require mechanical ventilatory support. You are called to the bedside by the ICU nurse because...
The patient is a 65 year-old man who has been in the MICU for 14 days with acute respiratory distress syndrome (ARDS). He had a...
Pediatric Asthma Requiring Airway in a Rural ED
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...
Shoulder Dystocia in a Rural ED
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...
Pediatric Asthma Exacerbation
Southeastern Illinois CollegeThe 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...
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...
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...
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...
Anesthesia Post-op
University of Pennsylvania School of NursingIn the Operating Room, a 23-year-old female patient with an undiagnosed pseudocholinesterase deficiency is undergoing general anesthesia for a D&E. As the surgical case is completed, the Student Registered Nurse Anesthetist (SRNA) turns the anesthesia off. Still, the deficiency causes the patient to remain under the influence of the paralytic...
In the Operating Room, a 23-year-old female patient with an undiagnosed pseudocholinesterase deficiency is undergoing general anesthesia for a D&E. As the surgical case is...
Tetralogy of Fallot with Hypercyanotic Spell
Children's NationalThe patient is a 2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. An IV was placed when the patient was in the triage area and the saturations since the arrival to the ED have been in the 60s. This scenario begins with a notably cyanotic infant with...
The patient is a 2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. An IV was placed when the patient was in the...
Preeclampsia
SimXYou are working in a rural Emergency Department. You see a 35 year-old female who comes into the emergency department for a headache. Through a proper history and physical, you also note right upper quadrant abdominal pain, leg swelling, and she is obviously pregnant. She is a G1P0 who is...
You are working in a rural Emergency Department. You see a 35 year-old female who comes into the emergency department for a headache. Through a...
Sepsis
SimXThe learner is working in the emergency department, going to see a 70-year-old male who is here with abdominal pain and fever. The patient was previously told his gallbladder was bad and needs to be removed. Upon initial assessment, the patient is febrile, tachycardic, and hypotensive. If treated aggressively with...
The learner is working in the emergency department, going to see a 70-year-old male who is here with abdominal pain and fever. The patient was...
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...
Hypotension Post TAA
University of Pennsylvania School of NursingPatient is s/p TEVAR for type B descending thoracic aortic aneurysm. Report from anesthesia states hemostasis achieved to bilateral groins and site looks fine. Two hours later, the patient begins to complain of overall “soreness” and pain in groins for which Morphine IV was given. Reassessment shows BP 98/70, HR...
Patient is s/p TEVAR for type B descending thoracic aortic aneurysm. Report from anesthesia states hemostasis achieved to bilateral groins and site looks fine. Two...
Severe Trauma
Sun City SimulationIn 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...
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...
Shortness of Breath
SimXIn this scenario, a middle-aged woman with multiple medical problems presents to the ED with one week of fever and cough with worsening shortness of breath. The learner must perform a full work up on the patient, develop a differential diagnosis, and treat the patient according to that diagnosis. There...
In this scenario, a middle-aged woman with multiple medical problems presents to the ED with one week of fever and cough with worsening shortness of...
Pediatric Dysrhythmia (Resuscitation)
SimXIn this scenario, a 9-year-old Hispanic male without any prior known medical history is brought in by EMS after collapsing during physical education class. The patient was transported to the emergency department by the emergency medical providers. During the assessment, the patient goes into ventricular tachycardia and the learner must...
In this scenario, a 9-year-old Hispanic male without any prior known medical history is brought in by EMS after collapsing during physical education class. The...
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...
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....
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...
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...