SIMULATION CASEBOOK - MyCourses

Gilbert Program in Medical Simulation
Simulation Casebook
Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12
VI.
VII.
VIII.
Instructors Notes
A. Tips to keep scenario flowing
B. Scenario programming
1. Optimal management path:
O 2 /IV/monitor
History and physical examination
Aggressive fluid resuscitation, benzos, cooling
Appropriate laboratory studies and images obtained
2. Potential complications/errors path(s):
Failure to initiate cooling, appropriate benzos/IVF
Administering large dose of B-blocker, Haldol
Debriefing Plan
A. Method of debriefing: Group with multimedia teaching materials
B. Debriefing materials: See Appendix C
C. Potential debriefing topics
1. Team dynamics
a. Leadership
b. Collaboration
c. Communication
d. Professionalism
2. Didactic material
a. Appropriate differential diagnosis, including various illicit intoxication:
Cocaine, Amphetamine, Crystal meth, Anticholinergics (e. reduced sweating
and garbled speech, “mouthful of marbles”), MDMA (diaphoresis and
normal but pressured speech)
b. Pathophysiology
i. Differences in isolated amphetamine toxicity
ii.
Cardiovascular/CNS stimulation, hyperthermia, hyponatremia,
serotonergic
c. Symptoms and patterns of intoxication/toxidromes
d. Management options
i. Medical management of drug-related issues
ii. Emergency management of seizure in this context
e. History of MDMA (3,4 methylenedioxyamphetamine)
i. 1914: Initially appetite suppressant
ii. 1970s: Psychotherapeutic but found to be too addictive
iii. Now: “circuit party” drug that induces euphoria, disinhibition,
wakefulness, intimacy, sexual arousal
Development and Deployment
This case was developed and deployed for independent study sessions among first and second year
medical students.
IX.
Authors/Contributors
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.
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