Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation

Introduction Submersion injury or drowning is a leading preventable cause of pediatric mortality and morbidity. Submersion injuries are often accompanied by hypothermia and asphyxia that can lead to inadequate oxygen delivery to tissues and subsequent cardiac arrhythmias. Methods This simulation-bas...

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Main Authors: Anita Thomas, Elizabeth Sanseau, Neil Uspal, Rebekah Burns, Marc Auerbach, Derya Caglar, Kimberly Stone, Jennifer Reid
Format: Article
Language:English
Published: Association of American Medical Colleges 2017-10-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.10643
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author Anita Thomas
Elizabeth Sanseau
Neil Uspal
Rebekah Burns
Marc Auerbach
Derya Caglar
Kimberly Stone
Jennifer Reid
author_facet Anita Thomas
Elizabeth Sanseau
Neil Uspal
Rebekah Burns
Marc Auerbach
Derya Caglar
Kimberly Stone
Jennifer Reid
author_sort Anita Thomas
collection DOAJ
description Introduction Submersion injury or drowning is a leading preventable cause of pediatric mortality and morbidity. Submersion injuries are often accompanied by hypothermia and asphyxia that can lead to inadequate oxygen delivery to tissues and subsequent cardiac arrhythmias. Methods This simulation-based curriculum involves the identification and management of a submersion injury in a 4-year-old boy who was rescued from a cold-water submersion. The simulated patient is apneic, pulseless, bradycardic, and hypothermic; he is being bag-mask ventilated on arrival without intravenous access. He ultimately develops ventricular fibrillation. Providers must recognize the degree of submersion injury, initiate early airway protection, adequately address circulation, and be alert to developing hypothermia and cardiac arrhythmias to prevent further decompensation. This scenario can be modified based on trainee level (pediatric residents vs. pediatric emergency medicine fellows). Results A total of 22 trainees (PGY 1-PGY 6 pediatric residents and pediatric emergency medicine fellows) participated in this simulation curriculum on separate occasions and rated it as an overall positive learning experience. The curriculum's goal is to provide learners with an opportunity to manage life-threatening pediatric submersion injuries, where the correct steps need to be taken in a limited period of time. Discussion We have provided preparatory materials to help instructors set up, run, and debrief the scenario in a standardized fashion. The debriefing tools allow for adaptation depending on learners' needs and individual experiences during the simulated scenario. Also included are supporting educational materials and a learner feedback form that can be used to evaluate the session.
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spelling doaj.art-d2be9afa3b0f4ca59b21f2d4cd83906f2022-12-21T17:49:24ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652017-10-011310.15766/mep_2374-8265.10643Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular FibrillationAnita Thomas0Elizabeth Sanseau1Neil Uspal2Rebekah Burns3Marc Auerbach4Derya Caglar5Kimberly Stone6Jennifer Reid7Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalPediatric Resident, Seattle Children's Hospital; Pediatric Resident, University of Washington School of MedicineAssistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalAssistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalAssociate Professor of Pediatric Emergency Medicine and Emergency Medicine, Department of Pediatrics, Yale School of Medicine; Associate Professor of Pediatric Emergency Medicine and Emergency Medicine, Department of Pediatrics, Yale-New Haven Children's HospitalAssociate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalCo-Director of Pediatric Emergency Medicine Simulation, Seattle Children's Hospital; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalCo-Director of Pediatric Emergency Medicine Simulation, Seattle Children's Hospital; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's HospitalIntroduction Submersion injury or drowning is a leading preventable cause of pediatric mortality and morbidity. Submersion injuries are often accompanied by hypothermia and asphyxia that can lead to inadequate oxygen delivery to tissues and subsequent cardiac arrhythmias. Methods This simulation-based curriculum involves the identification and management of a submersion injury in a 4-year-old boy who was rescued from a cold-water submersion. The simulated patient is apneic, pulseless, bradycardic, and hypothermic; he is being bag-mask ventilated on arrival without intravenous access. He ultimately develops ventricular fibrillation. Providers must recognize the degree of submersion injury, initiate early airway protection, adequately address circulation, and be alert to developing hypothermia and cardiac arrhythmias to prevent further decompensation. This scenario can be modified based on trainee level (pediatric residents vs. pediatric emergency medicine fellows). Results A total of 22 trainees (PGY 1-PGY 6 pediatric residents and pediatric emergency medicine fellows) participated in this simulation curriculum on separate occasions and rated it as an overall positive learning experience. The curriculum's goal is to provide learners with an opportunity to manage life-threatening pediatric submersion injuries, where the correct steps need to be taken in a limited period of time. Discussion We have provided preparatory materials to help instructors set up, run, and debrief the scenario in a standardized fashion. The debriefing tools allow for adaptation depending on learners' needs and individual experiences during the simulated scenario. Also included are supporting educational materials and a learner feedback form that can be used to evaluate the session.http://www.mededportal.org/doi/10.15766/mep_2374-8265.10643SimulationVentricular FibrillationHypothermiaDrowningPediatric Emergency MedicineSubmersion
spellingShingle Anita Thomas
Elizabeth Sanseau
Neil Uspal
Rebekah Burns
Marc Auerbach
Derya Caglar
Kimberly Stone
Jennifer Reid
Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
MedEdPORTAL
Simulation
Ventricular Fibrillation
Hypothermia
Drowning
Pediatric Emergency Medicine
Submersion
title Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
title_full Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
title_fullStr Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
title_full_unstemmed Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
title_short Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation
title_sort pediatric emergency medicine simulation curriculum submersion injury with hypothermia and ventricular fibrillation
topic Simulation
Ventricular Fibrillation
Hypothermia
Drowning
Pediatric Emergency Medicine
Submersion
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.10643
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