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Gilbert Program in Medical Simulation Simulation Casebook Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12 iii. Mechanism of antiemetics iv. Abortive medications v. Teaching patient to recognize signs of aura VIII. Development and Deployment This case was developed for independent study sessions for first and second year medical students, and also used as a teaching module for third year clerkship students. IX. Authors/Contributions Case drafted by Kimberly Khoury, M.D., with contributions and updates by the Gilbert Simulation Team. Compiled and formatted by Elan Guterman. Reviewed and edited with references by Jeffrey Siegelman, M.D. and Zoë Howard, M.D. X. Reference a) Edlow, J, et al. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache. Ann Emerg Med. 2008;52:407-436. b) Headache classification subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004; 24 Suppl 1:9. c) Griffith JD, Mycyk MB, & Kyriacou DN. Metoclopramide Versus Hydromorphone for the Emergency Department Treatment of Migraine Headache. Journal of Pain, 2008. Vol 9 (1): p. 88 – 94. d) Coppola M, Yealy DM, & Leibold RA. Randomized, Placebo-Controlled Evaluation of Prochlorperazine Versus Metoclopramide for Emergency Department Treatment of Migraine Headache. Annals of Emegency Medicine, Nov 1995. 26 (5): p. 541 – 546. e) Colman, I, Friedman, BW, Brown, MD, et al. Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence. BMJ 2008; 336:1359. 120
Gilbert Program in Medical Simulation Simulation Casebook Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12 XI. Appendix A: Lab Values BASIC METABOLIC PANEL Reference Range Sodium 136 135-147 mmol/L Potassium 4.2 3.5-5.2 mmol/L Chloride 102 95-107 mmol/L CO 2 246 22-30 mmol/L Urea Nitrogen (BUN) 10 7-20 mg/dL Creatinine 1.0 0.5-1.2 mg/dL Glucose 100 60-110 mg/dL COAGULATION PROFILE Reference Range Partial thromboplastin time (PTT) 41 30 – 45 sec Prothrombin time (PT) 10 10 – 12 sec International Normalized Ratio (INR) 1.0 1 - 2 Fibrinogen 200 170 – 420 mg/dL COMPLETE BLOOD COUNT Reference Range Male Female White Blood Cell (WBC) 10,000 4,500 - 10,000 K/uL Hemoglobin (HGB) 10 13.5 - 16.5 g/dL 12.0 - 15.0 g/dL Hematocrit (HCT) 40 41 – 50% 36 – 44% Platelet 150,000 100,000 - 450,000 K/uL 121
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