SIMULATION CASEBOOK - MyCourses

Gilbert Program in Medical Simulation
Simulation Casebook
Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12
3. Program debugging: N/A
VII.
VIII.
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 of altered mental status: Electrolytes
(hyper/hypo: Na, glucose, Ca), uremia, hepatic encephalopathy, infection
(central and otherwise), head trauma, illicit substances, hypoxia/ hypercarbia,
primary neurologic process
b. Pathophysiology
c. Treatment
i. Initial workup: laboratory studies, studies, diagnosis-guided
treatment
ii. Discuss empiric role of Narcan/glucose
iii. Discuss why Flumazenil is not given empircally
d. Complications of mixed overdose
Development and Deployment
This case was developed for a widely subscribed fourth year medical school elective (emergency
medicine/transition to internship), and has been used over several years as part of an instructional module
for altered mental status/toxicology.
IX.
Authors/Contributors
Case drafted by Tania Fatovich, MD and Nancy Oriol, 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. References
a. Clarke, SFJ, et al. Naloxone in opioid poisoning: walking the tightrope. Emerg Med J
2005;22:612-616 .
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