Emergency Medicine HST Regional Training Day - WREMTA Sept 19

This day included paediatric themed simulations in the morning outlined below. Approximately 20 Higher Trainees from ST4-7 at various stages of the FRCEM examination. The simulation session was carried out in a training room using LifeCast Body Simulation manikin and basic kit. The monitoring and clinical parameters were controlled using ALSi software by iSimulate allowing the facilitator to control the patient monitor remotely.

The toxicology scenario required intubation where a McGrath video laryngoscope was used to intubate the manikin. The MedTronic rep was in attendance and gave a demo between the two scenarios before it was used in the scenario for real.

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First scenario: Severe sepsis in a 10 year old

Educational Goal: To manage a child with severe sepsis with refractory shock

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Clinical Objectives:

1. High flow oxygen administered
2. Monitoring and interpretation of observations
3. Circulation iv/io access
4. Fluid resuscitation (20ml/kg normal saline)
5. Specific therapy: antibiotics, inotropes
6. Contact local itu/ picu
7. Emergency drug calculator considered
8. SORT sepsis pathway
9. Call for help- local options- follow QAH pathway

Non Technical Objectives:

1. Communication with team
2. Communication with parents

Second scenario: Beta blocker overdose in an 8 year old

Educational Goal: To expose learners to managing a complex paediatric poisoning

Human Factors / Non Technical Objectives:

1. ‍‍Communicate clearly with team members using closed loop communication
2. Lead team members effectively through the management of a critically ill child
3. Effective use of cognitive aids (Toxbase and checklists)
4. Effective communication with parents
5. Using a 10 for 10 pause (10 seconds to save 10 minutes)
6. Use of a hot debrief for clinical staff

Clinical Objectives:‍

1. Take a focused history
2. Manage Atenolol overdose

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