This leads to hyperglycaemia, osmotic diuresis, and dehydration.
34 - Diabetic Ketoacidosis in Pregnancy | Obgyn Key - Associated symptoms 03:04 stream
Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. An individual student can get an immediate answer to a question, the facilitator can see puzzled expressions on faces, and the PBL group could get answers that they could not get during their prior PBL group discussions. }HyEf,#$/JSRU9+CF6k\'/z+i`[
5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! Inspect theairwayfor obviousobstruction. An integral part of a PBL session is for trainees to be able to navigate through huge literature bases. TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. The validity of the HFS-DKA scenario was verified by a certified diabetes nurse educator, a registered nurse, and a clinical nurse educator. It was Development of simulation scenarios for an adolescent patient with diabetic ketoacidosis. reduced air entry, coarse crackles) to screen for evidence of pneumonia. Environment & Manikin
Consider active re-warming techniques in patients with severe hypothermia. In the meantime, you should re-assess and maintain the patients airway. Search for Similar Articles
Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. Capillary refill timemay be prolonged if the patient is hypovolaemic. 2 0 obj
The main goal is to establish a safe learning environment for the learner [9, 13 . The objective is to give as many visual and tactile cues concerning the patient condition and background as possible. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel . The student group is given a short introduction into a closed simulation environment. Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department | Children's Hospital of Philadelphia Anesthetic Management Using the Oxygen Reserve Index for Tracheal Resection and Tracheal End-to-E A Scoping Review of the Impact of COVID-19 on Kidney Transplant Patients in the United States, Alabama College of Osteopathic Medicine Research, Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, DMIMS School of Epidemiology and Public Health, Simulation, Biodesign, & Innovation In Medical Education, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, VCOM Clinical, Biomedical, and Educational Research, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Medical Society of Delaware Academic Channel, Society for Healthcare & Research Development, Surgically Targeted Radiation Therapy for Brain Tumors: Clinical Case Review, Clinical and Economic Benefits of Autologous Epidermal Grafting, Defining Health in the Era of Value-Based Care, Optimization Strategies for Organ Donation and Utilization, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings. GRAPH. General: Moaning, asking what has happening to her. The facilitator guides the group only when necessary. insulin-dependent type 2 diabetes), Altered consciousness (e.g. Example: If the provider immediately evaluates blood glucose, then the reading will display 45 mg/dL. Deteriorationshould be recognised quickly and acted upon immediately. However, this turned out to be too slow, took too much time, and could not continuously demonstrate the direction of changes. 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.
Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario SimMan Nursing Scenarios Software - laerdal.com Mosby:Philadelphia. The simulation experience serves to give substance to the theoretical words and concepts that the students encountered during the PBL sessions. Could we not just do this as a large group session to all 160 students (versus 20 1-hour sessions to groups of eight students)? His Wife Gave Him CPR. The Simulation Laboratory session follows after a completed PBL session, and is aimed at making the case come alive, while providing a clinical perspective to preclinical students. oral fluids, intravenous fluids, urine output, drain output, stool output, vomiting) to inform resuscitation efforts. This article originally appeared in March 2011 JEMS as Diabetes Demonstration: Simulation-based learning works best., Simulation Training Ideal for Diabetic Patients, CMS Begins Reprocessing Retroactive Payments, Documents Detail EMTs Failure to Aid Tyre Nichols, New Course Lets Bystanders Be the Help Until Help Arrives, All Paramedic Recruits in New Castle County (DE) Obtain NRP Certification, International Prehospital Medicine Institute Literature Review, March 2023. Acad Med. The students have acquired all the applicable theoretical knowledge of the case during the previous multiday PBL sessions. cellulitis). Facebook: http://www.facebook.com/geekymedics Inspect for evidence of self-injection sites (e.g. This guide provides an overview of the recognition and immediate management of diabetic ketoacidosis (DKA)using an ABCDE approach. If the provider starts an IV and gives dextrose, then the patients alertness will increase, respirations will normalize and repeated blood glucose will read 210 mg/dL over a two-minute interval. Makeup may be used to depict gender, hollow eyes and cheeks, produce pallor or display bruises and scars. Use blankets to re-warm patients who are mild to moderately hypothermic. - Geeky Medics OSCE App: https://geekymedics.com/geeky-medics-app/ areas of lipohypertrophy) if it is unclear if the patient is diabetic. This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. Adds true to life parking codes and extra parking for AI. Lets discuss your options. 1. Marx JA, Hockberger RS, Walls RM. This typically involves the use of anon-rebreathe maskwith an oxygen flow rate of15L. %
Cureus 9(5): e1286. Prior to starting the scenario, the instructor should introduce a short summary of the case study and ask open-ended questions regarding the management direction.
2011;15:108109. DO NOT perform any examination or procedure on patients based purely on the content of these videos. The use of a simulated, evolving case scenario was an effective method of exposing nursing students to complex patient care. Just place the BR2_KDCA file into your addons scenery folder: C:\\Program Files\\Microsoft Games\\Microsoft Flight Simulator X\\Addon Scenery\\Scenery. An events progression section should include patient status changes, as well as a time/treatment continuum that incorporates if-then event progressions. Trainee will be respectful to others and their views during the PBL session. Therefore, we should not have to take much time on this issue, but we have to focus on the relationship between the biochemistry and clinical signs and symptoms by asking why the patient is dehydrated, why acidosis develops, why respiration is rapid and deep (Kussmaul) respirations, and what the rationale for inpatient treatment is. You may be trying to access this site from a secured browser on the server. Physician working in the emergency department. 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. The students are in their first year. One advantage to the animated lecture style is the ability to introduce treatment options in a methodically guided approach thats in conjunction with simultaneous environmental stimulus. Much time was wasted explaining why it did not matter. The debriefing environment should be removed from the location where the simulation took place.
Paediatric DKA | Simulation Education She is lethargic and slightly confused but can intermittently respond to questions. Make sure thepatientsnotes,observationchartandprescriptionchartare easily accessible. 3. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. Given 6 to 8 back-to-back sessions, it is critical that every session starts and ends on time! and Both external and internal potassium balances are disturbed during the development and treatment of DKA. Recognize the signs and symptoms of a patient presenting with diabetic ketoacidosis. 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. Introduceyourselfto whoever has requested a review of the patient andlistencarefullyto their handover. VbQuX#R M21 Privacy Policy When a group treatment decision is made that would be contraindicated or harmful to the patient, the instructor can redirect the learner group while maintaining an atmosphere inclined toward independent thinking. Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. Effectiveness of simulation on health profession students knowledge, skills, confidence and satisfaction. Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. Animated Lecture
Trainee will improve their understanding of clinical practice through reflective assessment of actual cases during the prior PBL sessions. Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. We guide the group to suggest fluid. 2008;6:278302. endobj
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Simulation student Scenario- DKA-Peds.docx - DIABETIC Healthcare Students' Psychological Well-Being in a Diabetic Ketoacidosis Simulation. <>
If the patient has clinical signs ofanaphylaxis(e.g. - Exacerbating & relieving factors 05:12
Pediatric Emergency Medicine Didactics and Simulation (PEMDAS To read Pages full Research Review column, visit www.jems.com/patient-care. Simulation Scenario for Anesthesia Providers Clark Obr, MD*, Anthony Mueller, MD *Corresponding author: clark-obr@uiowa.edu Abstract Introduction: This simulation on diabetic ketoacidosis (DKA) in . Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. 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) Complete the assigned suggested readings 3) Complete the presimulation preparation virtual simulation game (Instructor will provide link) 4) Once you have completed reading this document and prepared for your simulation, please: a. Categories: Emergency Medicine, Medical Education Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine . With your index and other fingers placed behind the angle of the mandible, apply steady upwards and forward pressure to lift the mandible. Heart: S1 and S2 within normal limits; no S3/S4 or murmurs, normal rate and rhythm. Assess the patients level of consciousness using the AVPU scale: If a more detailed assessment of the patients level of consciousness is required, use the Glasgow Coma Scale (GCS). This guide has been created to assist students in preparing for emergencysimulationsessionsas part of their training,it is not intended to be relied upon for patient care. The purpose of this simulation is to demonstrate the specific clinical signs of the patients with DKA, and the keys by which we recognize DKA in the early stages. Insert the airway bevel-end first, vertically along the floor of the nose with a slight twisting action. Each PBL case typically goes over 23 days, affording the students periods to find information for the case. Trainee will recognize and interpret the clinical signs and symptoms and the typical history of a patient with DKA, as well as understand the major causative factors of DKA. Emergency medical services workLife characteristics contribute to clinically significant excessive daytime sleepiness. This environment doesnt allow the student to identify presentation cues, be active in their own learning or apply their skills without endangering the lives of patients.(2). The instructors never expect the trainees to exhibit full understanding of pathophysiology and skills in the treatment but do give them a few important points to understand the diagnosis and initial treatment of the patients with DKA. If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. Therefore, the session is divided into four sections of 15 minutes each, so that the facilitator is constantly aware of being on time (or not), even after the first 15 minutes period. Trainee will appropriately request assistance and use available resources.
Pediatric Emergency Medicine Didactics and Simulation (PEMDAS She tends to drink sugar containing fluids (soda) when she is thirsty, and she eats fast foods (cream-filled muffins) when she is hungry. - Site 01:12 We do not use passive visualizing materials such as videotapes or DVD other than vital signs shown on the monitors. The instructors role is to facilitate active learning through a combination of learning styles. Review the patients drug chart for medications which may cause a reduced level of consciousness (e.g. We are adding to their theoretical knowledge by introducing them to physical objects, dynamic moving vital sign signals, and a moving, breathing simulated patient to make the case come alive. Discuss the patients current clinical condition with aseniorclinicianusing anSBARR style handover. This is a 25-year-old woman with a medical history of diabetes medicated with 40 units insulin per day. Instructors should write a case study for the simulation before the session. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. A collection of surgery revision notes covering key surgical topics. 2. A hyperglycemic patient may present with tachypnea, which often presents as Kussmauls respirations, tachycardia, orthostatic blood pressure changes and other signs of dehydration and diabetic ketoacidosis (DKA). 4. opioids, sedatives, anxiolytics, insulin, oral hypoglycaemic medications).
Simulation of Diabetic Ketoacidosis for Cellular and Molecul The simulation session is also hosted as an interactive session. See ourintravenous cannulation guidefor more details. Should any changes be made to the current management of their underlying condition(s)?
PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency The researchers found that long shift hours (24hrs), working overtime and marital/relationship stress were strongly correlated. Using the arterial line, the scenario becomes much more dynamic.
Kymera Systems Inc | SCADA Online Demo Ignition Laschinger S, Medves J, Pulling C, et al. Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario Cureus. A traditional classroom lecture format allows for student participation but limits the instructors ability to create realistic situations. You might also be interested in our awesome bank of 700+ OSCE Stations. - 150+ PDF OSCE Checklists: https://geekymedics.com/pdf-osce-checklists/ DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. 1) Please read through this document as it will help you prepare for your upcoming simulation on DKA. Strategies of high-performing paramedic educational programs. J Nurs Educ. may email you for journal alerts and information, but is committed
Use an effectiveSBARR handoverto communicate the key information effectively to other medical staff.
Creating a Simulation Experience to Promote Clinical Judgment PDF DKA Sim Scenario - ABCD (Diabetes Care) Ltd <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Assess the patients pulse and blood pressure: Inspect the patient from the end of the bed: they may appear drowsy, confused and/or clammy/pale. It may be necessary toexposethe patient during your assessment: remember to prioritise patient dignity and conservation of body heat. Does the patient need reviewing by a specialist? Administer oxygen to all critically unwell patients during yourinitialassessment. Vital Signs: BP, 90/30 mm Hg (ECG shows normal sinus rhythm); central venous pressure, 0 to 2 cm H. Lungs: All lung fields are clear to auscultation without wheeze or rhonchi, and the respiratory pattern is typical of Kussmaul breathing, ie, large deep tidal volumes and increased respiratory rate. Groups of fewer than four students dont allow for optimal collaboration. In other words, they do not have clinical experience, but they have clinical knowledge. We introduce the Simulation Laboratory and the Simulator, and demonstrate: pulses, eyes blinking, pupil constriction, gas moves in and out of mouth (place hand over mouth), chest moves up and down. Over the years, some groups happened to have the simulation session before the completion of the theoretical PBL session. The choice of fluid type, rate of administration and volume should be tailored to the individual patient based upon their vital signs and electrolytes. Consider any precipitating factors for the development of DKA and involve the diabetes team in the patients care. We give the history of the patient to the trainees. The use of case-based simulation, although more complicated and time consuming for the instructor, immerses the students in the subject matter. After the initial treatment is initiated, by showing a simulated urine and blood, and by getting them to smell ketones, we can enable the trainee to confirm the diagnosis of DKA. 2 The evaluation of potassium deficits is complicated by potassium exit from . The required potassium replacement varies greatly. Clearly communicate how often would you like the patients observations relayed to you by other staff members. His Heart Stopped On a Treadmill. During the debriefing process that follows the simulation, well-balanced performance measures will guide feedback toward accomplished tasks and may illustrate existing decision-making, behavioral or technical skill deficits. The following scenarios are available for download and are designed to meet your multi-disciplinary nursing needs.
Outcomes Educating Nursing Students Using an Evolving, Simulated Case The lecture allows for understanding of concepts prior to action, and instructor feedback is immediate. DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. If an infection is suspected, IV antibioticsshould be administered as soon as possible. 3 0 obj
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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. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of . Review the patientscurrent medicationsand check any regular medications areprescribed appropriately. Please write a single word answer in lowercase (this is an anti-spam measure).
Testing a diabetes keotacidosis simulation in critical care nursing: A Seek senior helpif the patient shows no signs of improvement or if you have any concerns. Works with Traffic 2005, but . When erroneous treatment is delivered, the instructor can end the simulation. We then start the DKA state. See Appendix D, Supplemental Digital Content 4, https://links.lww.com/SIH/A4. The main purpose of the simulation is to draw a line from the theoretical, boring biochemistry to the clinical manifestations. A GCS of 8 or below warrants urgent expert help from an anaesthetist. Re-assessthe patient using theABCDE approachto identify any changes in their clinical condition and assess the effectiveness of your previous interventions. After entering the environment, the student doesnt have the option of leaving the simulation until the learning objectives and performance measures are achieved. Available from: [. We found it more important to have the students full attention so that they could concentrate on concepts and not on menial tasks such as recording data. 3. The consequences (low blood pressure, high heart rate, central nervous system status, etc.) The addition of a fluid infusion containing some potassium allows insulin therapy to continue to suppress ketogenesis and normalise plasma pH whilst preventing the development of hypokalaemia.
Respiratory Failure in the Course of Treatment of Diabetic Ketoacidosis #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals, Cardiovascular History Tips - DON'T FORGET these 3 things .