SIMULATION CASEBOOK - MyCourses

Gilbert Program in Medical Simulation
Simulation Casebook
Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12
Cardiogenic Shock
I. Target Audience: Medical Students, Residents
II.
Learning and Assessment Objectives
Participants are expected to understand the scientific and humanistic issues underlying the disease
assessment and treatment plan, and to critically consider and deploy the therapeutic options described
Participants should provide a concise presentation of the patient to each physician consultant who
participates in the exercise. Debriefing sessions by on-site clinical faculty is essential to discuss critical
thinking and knowledge pathways, and to provide a forum for individual and team reflection on learning
and practice goals. While the case descriptions are written with medical terminology, it is important that
the provider and patient (i.e. the simulator) engage in authentic dialogue with lay terminology to reflect
an actual patient encounter.
Critical Actions Checklist:
DONE CRITICAL ACTION
Telemetry monitoring
Patient history
Physical examination
Supplemental O 2
IV Access
Immediate ECG and portable CXR (within 10 minutes of start of case)
Obtain appropriate laboratory studies: troponin, cbc, chemistry
Administer immediate aspirin
Increase cardiac output with pressor agent
Administer anticoagulation medication
Consult cardiology for further treatment
III.
IV.
Environment
A. Simulation room set up: Emergency Department
B. Manikin set up:
1. High fidelity patient simulator
2. No moulage needed
3. Lines needed
C. Props:
1. Code blue cart
2. Lab values (see Appendix A)
3. Images (see Appendix B)
D. Distracters: none
Actors
A. Nurse: facilitate scenario
B. Consultants: Cardiology for EKG interpretation and management, Primary care provider
if the students need prompting in general (optional for higher level residents who can provide
interpretation on their own)
25