We also show them IV bags containing saline and Ringers lactate, as well as show them IV infusion sets. This session provides additional clinical support material for the theoretical PBL session. Use washable, non-toxic paints to imitate various body emissions. An integral part of a PBL session is for trainees to be able to navigate through huge literature bases. She does not take this regularly. Simulation in Healthcare4(4):232-236, Winter 2009. <> 4. Consider active re-warming techniques in patients with severe hypothermia. We guide the group to suggest fluid. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. DOWNLOAD Diabetic Ketoacidosis By the end of this scenario, the learner will be able to: 1. We have been presenting Simulation Laboratory sessions to our preclinical medical students (first and second years). The objective is to give as many visual and tactile cues concerning the patient condition and background as possible. Two abstracts related to sleepiness in the EMS workforce were presented at the National Association of EMS Physicians symposium in January. }HyEf,#$/JSRU9+CF6k\'/z+i`[ 5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. Performing an ECG should not delay the emergency management of DKA. From the Department of Anesthesiology, Pennsylvania State University College of Medicine, Hershey, PA. Dr. Murray is on the Speakers Bureau of METI, Sarasota, FL. Published August 2015. Abstract Introduction: This simulation on diabetic ketoacidosis (DKA) in the obstetric population presents learners with one of the more commonly encountered etiologies of critical illness in the pregnant patient. The instructor can also gauge the direction the debriefing session should follow or be alerted to possible problems or conflicts in treatment opinions. In some cases, normal saline with additional potassium is required to prevent overcorrection of serum potassium levels which would otherwise result in hypokalaemia. The learning objectives follow the American College of Graduate Medical Education (ACGME) Core Compentencies. Management of diabetic ketoacidosis in adults. Are any further assessments or interventions required? We try to provide sufficient realism.. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. 2. See our blood glucose measurement guide for more details. Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. The use of simulation-based instruction enables a student to learn at their own pace and allows them to repeat sequential steps to gain confidence and proficiency. Each PBL case typically goes over 23 days, affording the students periods to find information for the case. Yes: if the patient can talk, their airway is patent and you can move on to the assessment of breathing. 6. Questionswhich may need to be considered include: The next team of doctors on shift should bemade awareof any patient in their department who hasrecently deteriorated. In this manner, the students have to apply their knowledge at the appropriate points during the progression of the scenario. Evenly balancing performance measures will ensure the student has the opportunity to critically think through patient treatment and to practice new or support previously learned behaviors and technical skills. Acad Med. There are actually two sets of educational objectives: the first set is for the theoretical PBL sessions, and the 2nd set is for the Simulation Session. During an immersive simulation, its imperative the group uses critical-thinking skills and group collaboration independently. Animated Lecture If the patient isunconsciousorunresponsive, start thebasic life support(BLS)algorithmas per resuscitation guidelines. - 700+ OSCE Stations: https://geekymedics.com/osce-stations/ A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Note that if-thens must also include negative patient outcomes for when the provider doesnt take appropriate action. Wolters Kluwer Health Conclusion: Our DKA simulator is a new tool whose objective is the training in a severe, frequent and complex situation, and can be used to improve the approach made by the junior physicians to the real diabetic . Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, Get new journal Tables of Contents sent right to your email inbox, SIH_13_4_2018_08_03_KOBAYASHI_17-00153_SDC5.tif; [Other] (3.04 MB), SIH_4_4_2009_10_29_NANDATE_200199_SDC2.doc; [Word] (68 KB), SIH_4_4_2009_10_29_NANDATE_200199_SDC3.doc; [Word] (29 KB), SIH_4_4_2009_10_29_NANDATE_200199_SDC4.doc; [Word] (40 KB), Simulation of Diabetic Ketoacidosis for Cellular and Molecular Basics of Medical Practice, Articles in PubMed by Koichiro Nandate, MD, PhD, Articles in Google Scholar by Koichiro Nandate, MD, PhD, Other articles in this journal by Koichiro Nandate, MD, PhD, Privacy Policy (Updated December 15, 2022). Place one hand on the patients forehead and the other under the chin. The teaching of diabetic assessment and management, like many other medical emergencies, lends itself well to case-based simulation. Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. These are not learning objectives in this program. #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals #shorts, Cardiovascular Exam Tips - DON'T FORGET these 3 things , Watch this video to find out the most COMMONLY FORGOTTEN components of the cardiovascular history! Save this video to help prepare for your upcoming OSCEs and dont forget to follow Geeky Medics! The reason for inserting the airway upside down initially is to reduce the risk of pushing the tongue backwards and worsening airway obstruction. We used the Medical Education Technologies Inc. (METI) Human Patient Stimulator (HPS, METI Sarasoto, Fl). As individuals with uncontrolled type I . - Severity 05:32 The students are in their first year. However, we should not spend too much time on (not become distracted with) explaining unfamiliar monitors for the present trainees, such as central venous pressure or ETCO2 concentration. Some error has occurred while processing your request. See ourCXR interpretation guidefor more details. - Associated symptoms 03:04 - 150+ PDF OSCE Checklists: https://geekymedics.com/pdf-osce-checklists/ Join the Geeky Medics community: Diabetes mellitus affects nearly 7.8% of the U.S. population, with approximately 510% of this group affected by Type I and 9095% by Type II.1 Diabetes is the most common type of endocrine disease and was the seventh leading underlying cause of death listed on death certificates in 2006. Please note that by doing so you agree to be added to our monthly email newsletter distribution list. Its absolutely necessary to follow all immersive simulations with a positive, emotionally safe and nonjudgmental debriefing environment. The instructors have to appreciate that the trainees participating in this simulation have not seen a diabetic patient in either a ward or ER, but that they have knowledge of the underlying physiology. - Radiation 02:45 1 0 obj We have spent many hours debating whether the small group format was a waste of time. This is a combination of the modified traditional lecture within scenario-based learning. Medical Simulation Scenarios are text documents outlining the various details of a simulation - everything from patient simulator settings to debriefing notes.Below is a collection of donated scenarios for you to use or modify. Her medical, social, and family histories are not clear at the time of admission to the emergency department. Observe and discuss the effects of therapy in a mathematically modeled physiological simulator. Trainee will be able to apply skills of communication with the simulated patient in a semiacute crisis to get sufficient important information for a final diagnosis. The students mentioned that they did not obtain the maximum value from the simulation session under these circumstances. Search for Similar Articles You could also ask a student to smear a small amount of acetone on a piece of glass to see how volatile it is, helping them understand why its being exhaled by the DKA patient. As the name says, this screen is used to graph and plot any parameter. Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most common in patients with type 1 diabetes in particular due to a deficiency or absence of insulin [1].. - Medical Finals Question Pack: https://geekymedics.com/medical-student-finals-questions/ You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. 2017 May 29;9(5):e1286. The Theory 3. Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. Privacy Policy We now provide the students with handouts of the data to save time and provide consistency. Well done, youve now stabilised the patient and theyre doing much better. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. PBL in our institution is implemented as a small group (n 68 students) self study session with a facilitator, who incrementally discloses further information about the patient. See ourhistory taking guidesfor more details. 3 0 obj The instructions to the facilitators suggest a series of structured, sequential questions to the students (starting at one end, involving each student in turn, and repeatedly cycling around the group.) DY{Qb"(EgN$QI*%XN1F""0a5 If the patient loses consciousness and there are no signs of life on assessment, put out a crash call and commence CPR. - Site 01:12 YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LjMxakdNallNcng0, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkJPVjVZMzBKczY4, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkxEM2VkQzB2NTBr, Start typing to see results or hit ESC to close, Deep Vein Thrombosis (DVT) Examination OSCE Guide, Pre-hospital Advanced Life Support (ALS) OSCE Guide, Adult Choking (Basic Life Support) OSCE Guide, Paediatric Intravenous Cannulation OSCE Guide, Intrauterine System (Mirena) Counselling OSCE guide, Geeky Medics OSCE Book | Clinical Examination, Paediatric Gastro-oesophageal Reflux Disease, A Career as a GP with Special Interest with Dr Fiona Mosgrove, Absolute insulin deficiency (e.g. Below is a collection of donated scenarios for you to use or modify. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ Instagram: https://instagram.com/geekymedics If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. We do have a wig that we place on the patient, but we do not try for full realism. For instance, if we mimicked the noise and traffic of a real emergency department, this would constitute excessive realism, and become a distraction to beginner medical students. Hypothermia may be present if the patient has been unconscious and exposed for some time. We ask the trainee why the blood pressure is so low or heart rate is so high, and how we should treat it. You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ to maintaining your privacy and will not share your personal information without We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. In the final 10 minutes, we show how the patient has a good recovery after fluid replacement. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! This style also doesnt mimic an actual scene, and a student may feel that treatment modalities and skills are performed at a slower rate than real-world applications. LYqC+pJ&6X4onfBT#?=R}.p8N3+Dk,P4tIgWB}-L'=8;_G >,K#.e89XnG'B~NtR