Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents
Introduction MDMA (3,4-methylenedioxymethamphetamine) is a popular drug of abuse associated with a variety of clinical manifestations. There are a number of life-threatening sequelae, including, but not limited to, agitated delirium, cardiac dysrhythmias, and hyperthermia. Similar to other substance...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2021-01-01
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| Series: | MedEdPORTAL |
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11092 |
| _version_ | 1818926133716975616 |
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| author | Ashlea Winfield Elizabeth Black Michelle Sergel |
| author_facet | Ashlea Winfield Elizabeth Black Michelle Sergel |
| author_sort | Ashlea Winfield |
| collection | DOAJ |
| description | Introduction MDMA (3,4-methylenedioxymethamphetamine) is a popular drug of abuse associated with a variety of clinical manifestations. There are a number of life-threatening sequelae, including, but not limited to, agitated delirium, cardiac dysrhythmias, and hyperthermia. Similar to other substances that cause sympathomimetic toxidromes, MDMA also induces a syndrome of inappropriate antidiuretic hormone secretion-like state resulting in hyponatremia. The management of hyperthermia is of particular importance, as time to correction, particularly at temperatures greater than 106 °F, is directly associated with increased risk of morbidity and mortality. Methods We created a simulation-based intervention to address and improve clinical skills relating to the management of MDMA intoxication. The scenario used a simulated patient to teach emergency medicine residents how to properly diagnose sympathomimetic toxicity and manage resultant hyperthermia and hyponatremia with cooling measures and appropriate fluid administration. Learners participated in a debrief session and were given an anonymous survey to assess their perceived knowledge. The case was performed as part of monthly emergency medicine resident didactics. Results Eighteen learners took part in the case, with a 100% response rate. All participants agreed that the scenario increased their knowledge of cooling methods in severe hyperthermia, particularly whole-body packing. Eighty-nine percent (n = 16) reported that the scenario changed their practice patterns. Discussion This simulated scenario requires minimal resources and can be instituted with emergency medicine residents from all levels of training. The scenario achieved its primary goal of improving residents' perceived knowledge of cooling measures in severe hyperthermia. |
| first_indexed | 2024-12-20T02:52:17Z |
| format | Article |
| id | doaj.art-24901a0a312943eda973208c2958158f |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-20T02:52:17Z |
| publishDate | 2021-01-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-24901a0a312943eda973208c2958158f2022-12-21T19:55:59ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652021-01-011710.15766/mep_2374-8265.11092Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine ResidentsAshlea Winfield0Elizabeth Black1Michelle Sergel2Simulation Fellow, Department of Emergency Medicine, Cook County HealthToxicology Fellow, Department of Emergency Medicine, Cook County HealthDirector of Cook County Simulation Center, Department of Emergency Medicine, Cook County Health; Co-Executive Director, Rush Center for Clinical Skills and SimulationIntroduction MDMA (3,4-methylenedioxymethamphetamine) is a popular drug of abuse associated with a variety of clinical manifestations. There are a number of life-threatening sequelae, including, but not limited to, agitated delirium, cardiac dysrhythmias, and hyperthermia. Similar to other substances that cause sympathomimetic toxidromes, MDMA also induces a syndrome of inappropriate antidiuretic hormone secretion-like state resulting in hyponatremia. The management of hyperthermia is of particular importance, as time to correction, particularly at temperatures greater than 106 °F, is directly associated with increased risk of morbidity and mortality. Methods We created a simulation-based intervention to address and improve clinical skills relating to the management of MDMA intoxication. The scenario used a simulated patient to teach emergency medicine residents how to properly diagnose sympathomimetic toxicity and manage resultant hyperthermia and hyponatremia with cooling measures and appropriate fluid administration. Learners participated in a debrief session and were given an anonymous survey to assess their perceived knowledge. The case was performed as part of monthly emergency medicine resident didactics. Results Eighteen learners took part in the case, with a 100% response rate. All participants agreed that the scenario increased their knowledge of cooling methods in severe hyperthermia, particularly whole-body packing. Eighty-nine percent (n = 16) reported that the scenario changed their practice patterns. Discussion This simulated scenario requires minimal resources and can be instituted with emergency medicine residents from all levels of training. The scenario achieved its primary goal of improving residents' perceived knowledge of cooling measures in severe hyperthermia.http://www.mededportal.org/doi/10.15766/mep_2374-8265.11092Sympathomimetic ToxidromeMDMA3,4-Methylenedioxymethamphetamine (MDMA)HyperthermiaSymptomatic HyponatremiaEmergency Medicine |
| spellingShingle | Ashlea Winfield Elizabeth Black Michelle Sergel Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents MedEdPORTAL Sympathomimetic Toxidrome MDMA 3,4-Methylenedioxymethamphetamine (MDMA) Hyperthermia Symptomatic Hyponatremia Emergency Medicine |
| title | Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents |
| title_full | Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents |
| title_fullStr | Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents |
| title_full_unstemmed | Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents |
| title_short | Sympathomimetic-Induced Hyperthermia and Hyponatremia: A Simulation Case for Emergency Medicine Residents |
| title_sort | sympathomimetic induced hyperthermia and hyponatremia a simulation case for emergency medicine residents |
| topic | Sympathomimetic Toxidrome MDMA 3,4-Methylenedioxymethamphetamine (MDMA) Hyperthermia Symptomatic Hyponatremia Emergency Medicine |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11092 |
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