Med Surg Post OP then PE to ICU Intubated

[JEdwards]

This is for 4th semester students really a three part scenario
Part #1 (No Monitor Med Surg) Use Standard Man
The patient is a (age you make up) male post op above the knee amputation I use left leg. Day 1 nurse is given report and he is stable with some bleeding on amputation dressing site (stain faux blood on 4X4 and let dry now put guaze over and let it show through). Patient is complaining of pain and phantom leg. Objective is pain assesment and medications given along with how to handle a patient that expresses phantom pain. Also safety as the call light is placed under bed. Props include on tray in front of patient is medications in med cup (candy) this is one that usually gets missed.
Vitals are given if asked (normal)

Debrief: Don't clue them about medications on table yet you still have two more scenarios to build on to see if anyone else notices. Did they wash hands?

Part #2 (No Monitor Med Surg) Use Standard Man
The patient Vitals are bordering normal. Use Phantom pain as a focus (Please scratch my big toe it itches or rub my leg) Some will be lost most sound like a broken record stating phantom pain or sensation is normal. I use role play a visitor spouse or sibbling go up to patient and use a spray bottle with water and glycerin spray on face and chest and say you are sweating. Patient complains chest pain and difficulty breathing. Pain is worse and breathing more difficult. Say patient is clutching chest (the Vitals are worsing if they ask). Objective is assesment, give O2 nonrebreather mask, call a rapid response.

Debrief: Again don't clue them about medications on table yet you still have one more scenario to run to see if anyone else notices. Did they wash hands?



Part #3 Patient in ICU hooked up to ventilator and monitor and IV Use Standard Man then overlay ARDS with Vent Mangement (wait for over lay for a while into scenario)
Patient in ICU room eyes closed they have to introduce themselves. Do they wash hands? Now patient opens eyes and closes to commands if needed.
Then patient gurgles (needs to be suctioned) When suctioned I make sound in microphone (Cuwaaaaaaaaaaaaaaswush Cuuuuuuuuuuuuwashs listen to a real paitent being suctioned to hear sound it is gross) Now when every thing is going fine I send a role of Respiratory Therapist Sudent to check vent and have them turn vent off saying it is broken and they run out. Backing up just as they enter room run overlay. Patient get sicker and I give patient blood volume a few times (not objective). No patient is crashing montor is alarming. The student is now at make or break point and fail or perform.
Obejective this time is introduction to patient who can't speak, comfort, wash hands, safety is call light available and all lines secured properly, airway mangement with bag mouth mask for intubated patient.

Debrief: Let all students bag patient and show medications and discuss.

If you have any questions about this contact me at 310-257-5783

[viper2lt]

hi jedwards! these are pretty cool stuff... i might need help with something else in running my own scenarios. can i give you a call when i do? thanks