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Critical Care

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Myocardial Infarction in the ED

Southeastern Illinois College

A 57-year-old male presents to the Emergency Department with chest pain. He reports that the pain started about an hour after dinner, while he was working. He describes the pain as a “crushing pressure” located midsternal and radiating down his left arm and to his back. He rates the pain...

Cardiac/Telemetry Cardiology Critical Care Emergency Emergency Medicine Internal Medicine

A 57-year-old male presents to the Emergency Department with chest pain. He reports that the pain started about an hour after dinner, while he was...

Case Information:
Bundles:
Learner Population: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine, Cardiac/Telemetry, Emergency
Author: Southeastern Illinois College
Language: English
Room size: 16x13
Setting: Emergency Department
Patient ect:
Patient Gender: Male
Tags: A-Fib, acls, Amiodarone, Atrial Fibrillation, cardiac arrest, cardioversion, chest pain, defibrillation, epinephrine, inferior stemi, stemi, V-Fib, V-Tach, ventricular fibrillation, ventricular tachycardia,

ICU Sepsis – CVVHD

Houston VA

Nick O. Kidman, a 54-year-old male patient admitted from ED for COPD exacerbation and uncontrolled DM Type 2; was transferred to ICU from the medical floor unit ED 2 days ago for PNA, ARF/AKI, and Sepsis. Patient has AKI with hyperkalemic fluid-overload, requiring dialysis. He also has sever hypotension, requiring...

Critical Care

Nick O. Kidman, a 54-year-old male patient admitted from ED for COPD exacerbation and uncontrolled DM Type 2; was transferred to ICU from the medical...

Case Information:
Bundles:
Learner Population: Nursing
Specialty: Critical Care
Author: Houston VA
Language: English
Room size: 17x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: acute respiratory failure, copd, CRRT, CVVHD, diabetes, icu, Kidney Injury, Mellitus Type 2, pneumonia, sepsis, Vasopressors,

Tracheostomy Complications—Occluded Inner Cannula (Fresh Tracheostomy)

NYU Grossman School of Medicine

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 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...

Critical Care Internal Medicine Surgery

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Critical Care, Internal Medicine, Surgery
Author: NYU Grossman School of Medicine
Language: English
Room size: 17x17
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: ards, hypoventilation, hypoxia, inner cannula, occlusion, percutaneous, tension pneumothorax, Trach, tracheostomy,

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...

Anesthesiology Critical Care Emergency Medicine Internal 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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Anesthesiology
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,

Tracheostomy Complications—Displacement (Fresh Tracheostomy)

NYU Grossman School of Medicine

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 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...

Anesthesiology Critical Care Emergency Medicine Internal Medicine

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Anesthesiology
Author: NYU Grossman School of Medicine
Language: English
Room size: 17x17
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: ards, chest tube, hypoxemia, intubation, needle decompression, tension pneumothorax, Trach, tracheostomy,

Social Determinants of Health Bundle

SimX

This bundle focuses on the holistic approach to patient care, concentrating on the social determinants of health and health equity. Through these virtual patient encounters, learners experience various scenarios that highlight the complex social, environmental, and psychological factors affecting patient health. Each scenario is meticulously crafted to challenge the learner...

Cardiac/Telemetry Cardiology Community/Public Health Critical Care Emergency Medicine Internal Medicine Neurology OB/GYN Pediatric Psychiatry SDOH Surgery Trauma

Social Determinants of Health Bundle

Social Determinants of Health

This bundle focuses on the holistic approach to patient care, concentrating on the social determinants of health and health equity. Through these virtual patient encounters,...

Case Information:
Bundles: Social Determinants of Health
Learner Population: Nursing, Chiropractor, EMS/Prehospital, Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine, Neurology, OB/GYN, Pediatric, Cardiac/Telemetry, Community/Public Health, Psychiatry, SDOH, Surgery, Trauma
Author: SimX
Language:
Room size:
Setting:
Patient ect:
Patient Gender:
Tags:

Pediatric Asthma Requiring Airway in a Rural ED

Air Methods

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 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...

Critical Care Emergency Emergency Medicine Paramedic Pediatric

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...

Case Information:
Bundles:
Learner Population: Nursing, EMS/Prehospital, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Pediatric, Emergency, Paramedic
Author: Air Methods
Language: English
Room size: 17x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: asthma, ED, hypotension, intubation, pediatrics, refractory asthma, severe asthma, shortness of breath,

Sepsis

SimX

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 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...

Critical Care Emergency Medicine Geriatric Internal Medicine Surgery

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...

Case Information:
Bundles:
Learner Population: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Geriatric, Surgery
Author: SimX
Language: English, Spanish
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: abdominal pain, ED, emergency department, gallbladder, geriatric, hypotensive, PEA arrest, sepsis, septic shock, tachycardia,

Shortness of Breath

SimX

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 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...

Cardiology Critical Care Emergency Medicine Internal Medicine

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine
Author: SimX
Language: English, Spanish
Room size: 14x14
Setting: Hospital
Patient ect:
Patient Gender: Female
Tags: cough, covid, covid-19, differential diagnosis, dyspnea, fever, shortness of breath,

EMS TCA Overdose

SimX

This scenario begins in a patient’s home where paramedics were called because the patient is not acting right and is unresponsive. Their family believes the patient may have overdosed on medications as she has been depressed since breaking up with her girlfriend last week. The learner can observe several medication...

Critical Care Emergency Medicine Paramedic Toxicology

EMS TCA Overdose

EMS Bundle

This scenario begins in a patient’s home where paramedics were called because the patient is not acting right and is unresponsive. Their family believes the...

Case Information:
Bundles: EMS Bundle
Learner Population: EMS/Prehospital, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Paramedic, Toxicology
Author: SimX
Language: English, Spanish
Room size: 16x13
Setting: Ambulance, Home
Patient ect:
Patient Gender: Female
Tags: abc’s, abnormal ekg, abnormal vital signs, aspiration, ems, intubation, overdose, qrs, respiratory failure, sodium bicarbonate, suicide attempt, tca overdose, toxicology, unresponsive, ventricular tachycardia, wide qrs,

EMS Anaphylaxis

SimX

In this scenario, the patient presents with difficulty breathing. Learners will need to ascertain from the patient’s history that they were exposed to peanuts with a known allergy. The learner must give Epi and the patient will improve. However, the patient will require a second dose of epi. If neither...

Advanced EMT Critical Care Emergency Medicine EMT Paramedic

EMS Anaphylaxis

EMS Bundle

In this scenario, the patient presents with difficulty breathing. Learners will need to ascertain from the patient’s history that they were exposed to peanuts with...

Case Information:
Bundles: EMS Bundle
Learner Population: EMS/Prehospital, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Advanced EMT, EMT, Paramedic
Author: SimX
Language: English, Spanish
Room size: 12x6
Setting: Ambulance
Patient ect:
Patient Gender: Male
Tags: allergic reaction, allergy, anaphylactic shock, anaphylaxis, cardiac arrest, difficulty breathing, dyspnea, epinephrine, food allergy, peanut allergy,

EMS Inferior STEMI

SimX

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 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...

Advanced EMT Cardiology Critical Care Emergency Medicine Internal Medicine Paramedic

EMS Inferior STEMI

EMS Bundle

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...

Case Information:
Bundles: EMS Bundle
Learner Population: EMS/Prehospital, Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine, Advanced EMT, Paramedic
Author: SimX
Language: English
Room size: 12x6
Setting: Ambulance
Patient ect:
Patient Gender: Female
Tags: cardiac arrest, cardiogenic shock, cath lab activation, chest pain, fluid resuscitation, heparin, inferior stemi, nitroglycerin side effects, rv infarct, stemi,

Chest Pain in the ED (Resuscitation)

SimX

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. 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...

Cardiology Critical Care Emergency Medicine Internal Medicine

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....

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine
Author: SimX
Language: English, Spanish
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: cardiac arrest, chest pain, chest pain in the ed, dyspnea, exertional chest pain, pulmonary embolism, right heart strain, shortness of breath, thrombolytics,

GI Bleed

Ohio State University

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 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...

Critical Care Emergency Emergency Medicine Internal Medicine

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...

Case Information:
Bundles:
Learner Population: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Emergency
Author: Ohio State University
Language: English, Spanish
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: blood transfusion, causes of dizziness, causes of weakness, drowsy, gi bleed, hematemesis, hemorrhagic shock, hypotension, lightheaded, ng tube, pea, resuscitation, tachycardia, weak,

STEMI V-Fib Arrest

Ohio State University

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 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...

Cardiology Critical Care Emergency Medicine Internal Medicine

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...

Case Information:
Bundles:
Learner Population: Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine
Author: Ohio State University
Language: English
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: acls, arrhythmia, cardiac arrest, chest heaviness, chest pain, chest pain complications, code blue, defibrillation, stemi, v-fib arrest, ventricular fibrillation, ventricular tachycardia,

Tracheostomy Complications—Cuff Leak

NYU Grossman School of Medicine

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 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...

Critical Care Internal Medicine Paramedic

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...

Case Information:
Bundles:
Learner Population: EMS/Prehospital, Physician/Advanced Practice Provider
Specialty: Critical Care, Internal Medicine, Paramedic
Author: NYU Grossman School of Medicine
Language: English
Room size: 16x18
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: ards, cuff leak, icu, mechanical ventilation, tracheostomy, tracheostomy complications, tracheostomy exchange, ventilator alarm, ventilator alarms, ventilator care,

Sepsis Care

University of Nebraska Medical Center

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 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,...

Critical Care Emergency Medicine Geriatric Internal Medicine Leadership Surgery

Sepsis Care

SimX Nursing Bundle

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...

Case Information:
Bundles: SimX Nursing Bundle
Learner Population: Nursing, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Geriatric, Leadership, Surgery
Author: University of Nebraska Medical Center
Language: English
Room size: 15x15
Setting: Hospital
Patient ect:
Patient Gender: Female
Tags: abdominal infection, antibiotics, infection, sepsis, septic shock,

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...

Critical Care Emergency Medicine Family Medicine Geriatric Internal Medicine 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, Social Worker
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Family Medicine, Geriatric, 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,

Epileptic Seizure

Inselspital - Universitätsspital Bern

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 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,...

Critical Care Emergency Emergency Medicine Internal Medicine Neurology

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...

Case Information:
Bundles:
Learner Population: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Internal Medicine, Neurology, Emergency
Author: Inselspital - Universitätsspital Bern
Language: English
Room size: 18x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: epilepsy, headache, seizure, subarachnoid hemorrhage,

Chest Pain—ACS

Queensland Health Service

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 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...

Cardiac/Telemetry Cardiology Critical Care Emergency Medicine Internal Medicine Resuscitation

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...

Case Information:
Bundles:
Learner Population: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine, Cardiac/Telemetry, Resuscitation
Author: Queensland Health Service
Language: English
Room size: 16x13
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: acls, acute coronary syndrome, als, cardiac arrest, cardiology, chest pain, cpr, emergency medicine, myocardial infarction, stemi,

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,...

Critical Care Emergency Medicine Pediatric Resuscitation

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: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Pediatric, Resuscitation
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,

ACLS Knowledge Update

Air Methods

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 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...

Advanced EMT Cardiac/Telemetry Cardiology Critical Care Emergency Medicine Family Medicine Internal Medicine Paramedic Resuscitation

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...

Case Information:
Bundles:
Learner Population: Nursing, EMS/Prehospital, Interprofessional, Physician/Advanced Practice Provider
Specialty: Cardiology, Critical Care, Emergency Medicine, Internal Medicine, Advanced EMT, Cardiac/Telemetry, Family Medicine, Paramedic, Resuscitation
Author: Air Methods
Language: English
Room size: 15x15
Setting: Hospital
Patient ect:
Patient Gender: Male
Tags: acls, bls, bradycardia, cardiac arrest, cardioversion, defib, defibrillation, ems, ems cardiac arrest, sinus bradycardia, synchronized cardioversion., ventricular fibrillation, ventricular tachycardia, vfib, vtach,

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...

Anesthesiology Cardiac/Telemetry Critical Care Emergency Medicine Pediatric

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: Nursing, Interprofessional, Physician/Advanced Practice Provider
Specialty: Critical Care, Emergency Medicine, Pediatric, Anesthesiology, Cardiac/Telemetry
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,