SIMULATION CASEBOOK - MyCourses

Gilbert Program in Medical Simulation
Simulation Casebook
Harvard Medical School Draft of the 1 st edition (2011), updated 3/2/12
Appropriate lab workup: CBC, BMP, cardiac enzymes, coagulation
profile, D-Dimer
Appropriate imaging: CXR, ECG, CT angiography (Chest)
Administer anticoagulant (e.g. Heparin)
2. Potential complications/errors path(s):
Failure to initiate O 2 therapy
3. Program debugging: N/A
VIII.
IX.
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. Part I:
i. Differential diagnosis of chest pain
ii. Differential diagnosis of shortness of breath
b. Part II
i. Diagnosis
1. Decision Support (PERC score, Well’s criteria)
2. D-Dimer, CT angiography, V/Q scan
3. EKG findings (sinus tachycardia, uncommon RV strain
pattern: S1Q3T3)
ii. Treatment
1. Anti-coagulation vs thrombolysis vs embolectomy
Development and Deployment
This case was developed for second-year medical students as part of a core respiratory
physiology/pathophysiology class, and has been used as teaching module for third-year clerkship
students.
X. Authors/Contributors
Case drafted by Emily Hayden, 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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