Segments in this Video

Welcome to the Simulation (83:44)


Three case presentations and simulations are presented for review. Gilbert reviews key points to assist students thought the simulations. Debriefings allow for open dialogue and improvement.

Signs and Symptoms of Diabetic Ketoacidosis (180:00)

DKA develops when there is insufficient insulin resulting in fat breakdown and the production of ketones. Precipitating factors of DKA include infections and noncompliance with insulin therapy. Presenting symptoms of DKA include polydipsia, polyuria, polyphagia, and fruity odor.

Evaluating and Diagnosing Diabetic Ketoacidosis (00:0-15399)

Initial evaluation for DKA includes assessing cardiorespiratory status, volume status, mental status, and laboratory diagnostics. Diagnostic criteria are elevated serum glucose, acidic arterial pH, and elevated serum bicarbonate. Triad of hyperglycemia, anion-gap, and metabolic acidosis.

Treating Diabetic Ketoacidosis (02:46)

Protocols for treating DKA focus on correcting hypoglycemia, dehydration, electrolyte imbalances, and metabolic acidosis.

Overview of Gastrointestinal Bleeds (02:05)

Upper GI bleeds occur between the upper esophagus, duodenum, and ligamentum teres and are characterized by vomiting blood or coffee-ground material.

Clinical Assessment of Gastrointestinal Bleeds (02:13)

Initial assessment of patients with suspected GI bleeds should focus on hemodynamic stability and blood volume. Baseline labs include CBC, electrolytes, livers tests, coagulation studies, and cardiac enzymes.

Initial Interventions for Gastrointestinal Bleeds (03:54)

Oxygen, IV access, fluid resuscitation, blood transfusions, and proton pump inhibitors are high priority interventions for GI bleeds. If the patient is hypovolemic fluid resuscitation is critical. After an intervention is performed, their impacts must be assessed.

Overview of Pulmonary Embolism (03:23)

Pulmonary embolism are an obstruction of the pulmonary artery by a thrombus that originates elsewhere in the body. Categories of pulmonary embolism include acute, subacute, and chronic.

Stable Vs. Unstable (01:51)

Hemodynaically unstable patients are in a state of hypotension. Determining stable from unstable is critical in the treatment plan. Hemodynamically stable patients do not meet the definition of those that are unstable.

Clinical Presentation of Pulmonary Embolism (02:22)

Symptoms of pulmonary embolism vary and mimic symptoms of other conditions making diagnosis difficult. Common symptoms include dyspnea, chest pain, and cough. Diagnostic criteria used include a combination of tests.

Management of Pulmonary Embolisms (02:05)

Management of pulmonary embolisms require prevention and treatment strategies.

Patient Deterioration (04:11)

When patients begin to deteriorate, remember the ABC's- airway, breathing circulation. Best outcomes come from competent skills related to each of these categories. When patients suddenly change, identify potential problems such as hypoxia, hypoglycemia, hypovolemia, and arrhythmias.

Use of Simulation (00:18)

Gilbert introduces the goals and instructions for the three simulations. Simulations are used to enhance knowledge, skills, and attitude needed to provide safe and effective care.

Simulation One (08:08)

This simulation demonstrates a patient interview, assessment, diagnosis, and potential treatments of an upper gastrointestinal bleed. Gilbert reviews GI bleeds and the

Explanation of Simulation One (02:53)

Gilbert reviews upper GI bleeds and the case study presented in simulation one.

Simulation Two (07:40)

This simulation demonstrates a patient interview, assessment, diagnosis, and potential treatments of diabetic ketoacidosis.

Explanation of Simulation Two (06:00)

Gilbert reviews diabetic ketoacidosis and the case study presented in simulation two.

Simulation Three (15:31)

This simulation demonstrates a patient interview, assessment, diagnosis, and potential treatments of a pulmonary embolism. Code cart competent are reviewed.

Explanation of Simulation Three (06:43)

Gilbert reviews pulmonary embolisms and the case study presented in simulation three.

Simulation Summary (10:44)

A panel reviews the three simulations and discusses team dynamics and debriefings.

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Simulation Lab Scenarios to Prevent a Real Patient Crisis

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In this video, Robin Gilbert uses simulation scenarios to identify patients whose condition is deteriorating and determine the appropriate interventions and evaluate outcomes. The video presents simulations with mannequins for pulmonary embolism, shock, sepsis, respiratory crisis, and acute change in level of consciousness.

Length: 92 minutes

Item#: BVL148847

ISBN: 978-1-64347-251-5

Copyright date: ©2017

Closed Captioned

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