SIMULATION CASEBOOK - MyCourses

Gilbert Program in Medical Simulation
Simulation Casebook
Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12
***Failure to give supplemental O 2 and antipyretic within the first 10 minutes of the case will result in
increasing tachycardia and decreased O 2 saturation, the vitals will read:
HR BP Temperature ( o C) O 2 Sats (RA) RR
128 130/75 39.0 o 90% 28
V. Instructor Notes
A. Tips to keep scenario flowing
B. If students are unsure of pathology, prompting can come in form of a primary
care physician calling to check in on their patient.
1. laboratory studiesIf supplemental O 2 is not provided, nurse can verbalize need for
supportive care as patient becomes increasingly dyspneic
C. Scenario programming
1. Optimal management path:
O 2 /IV/monitor
History and physical examination
Appropriate lab workup: CBC, CMP, and consider ABG, blood culture,
sputum culture
Appropriate imaging: CXR, ECG
Administer antipyretics
Administer antibiotics
Determine need for hospital admission
2. Potential complications/errors path(s):
Failure to administer O 2
Failure to recognize need for antibiotics and possible hospital admission
3. Program debugging: N/A
VI.
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. Presentation
i. Appropriate differential diagnosis
ii. Based on the chest x-ray, discuss what would be expected on physical
examination of the chest
b. Pathophysiology
i. Likely cause of acute febrile illness
ii. Host defense mechanisms that are overcome for organism to cause
pneumonia
c. Etiology
i. Understand differences between community acquired, nosocomial,
and healthcare associated pneumonia
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