Happy New Year to Every Enthusiastic Simulation Expert!

The first post of this year is all about my very best simulation named “SimMarathon”.

I completed the 16th SimMarathon on December 29, 2015.
This endurance type crazy simulation seminar is definitely challenging for both facilitator and learners. If we were not enthusiastic about learning, it would make them stressed out by heavy tasks.

I love this simulation because there are very few fakes in terms of environment, patients’ data and devices used in this simulation.

This time, more than 20 healthcare providers joined and completed rather tough scenarios including two ECMO initiation, one REVOA and many Rapid Sequence Intubation (RSI) procedures for shock patients.

I have always wanted to add something new in this seminar, then one idea came up to my mind. That was an electric medical record, EMR. This time I let them write or add each patient’s information on pre-formatted word text and review them after each scenario finished. Even though the rpre-formatted style was not perfect yet, such tool will lead to much more realistic and effective education especially for young doctors.

Scenarios are as follows:

40M
CC: severe headache, vomiting
Diag: SAH(ruptured Acom aneurysm) with Takotsubo cardiomypathy
PH: none
Interventions: diazepam for seizure, brain CT, RSI→3D-CT Angio

44M
CC: burn
Diag: large burn by explosion, face to leg, TBSA 40%
PH: none
Interventions: fluid resuscitation based on Parkland formula, bronchoscopy and RSI, burn wound care

51M
CC: Trauma by falling from 4m height
Diag: traumatic SAH→VF due to AMI(Cardiogenic shock)
PH: HT
Interventions: Failed ACLS→VA-ECMO(ECPR) to manage persistent VF→PCI(POBA)

19M
CC: motorbike accident, blunt trauma, rt. chest pain
Diag: rt tension pneumothorax, rib fracture, aortic injury, lung and liver contusion
PH: none
Interventions: needle decompression→chest tube, CECT, IVR, BP control

53M
CC: altered consciousness, vomiting, sweating, miosis, fasciculation
Diag: organophosphate poisoning
PH: HT, HL, depression
Interventions: airway emergency by massive secretion→RSI, atropine + PAM

50F
CC: syncope,chest discomfort
Diag: long flight→DVT/massive PE (Clinical Scenario 5)
Interventions: limited amount of fluid resuscitation, RSI with ketamine/catecholamine→VA-ECMO→CECT
PH: overweight

66M
CC: altered consciousness, severe shock, vomiting and diarrhea
PH: none
Diag: AOSC, septic shock
Interventions: EGDT with Norad and vasopressin, EST/ENBD

16F
CC: death leap
Diag: pelvic fracture, multiple limb fractures, hemorrhagic shock, rt. pneumothorax
PH: very early phase of pregnancy
Interventions: transient responder →REVOA(IABO), blood O-type transfusion → CECT→TAE to blt internal iliac arteries