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Thomas A, Sanseau E, Uspal N, et al. Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation. MedEdPORTAL. 2017;13:10643doi: 10.15766/mep_2374-8265.10643.
Thomas, A., Sanseau, E., Uspal, N., Burns, R., Auerbach, M., Caglar, D., Stone, K., & Reid, J. (2017). Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation. MedEdPORTAL : the journal of teaching and learning resources, 1310643. https://doi.org/10.15766/mep_2374-8265.10643
Thomas, Anita, et al. "Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation." MedEdPORTAL : the journal of teaching and learning resources vol. 13 (2017): 10643. doi: https://doi.org/10.15766/mep_2374-8265.10643
Thomas A, Sanseau E, Uspal N, Burns R, Auerbach M, Caglar D, Stone K, Reid J. Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation. MedEdPORTAL. 2017 Oct 17;13:10643. doi: 10.15766/mep_2374-8265.10643. PMID: 30800844; PMCID: PMC6338133.
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MedEdPORTAL. 2017 Oct 17;13:10643. doi: 10.15766/mep_2374-8265.10643.

Pediatric Emergency Medicine Simulation Curriculum: Submersion Injury With Hypothermia and Ventricular Fibrillation.

MedEdPORTAL : the journal of teaching and learning resources

Anita Thomas, Elizabeth Sanseau, Neil Uspal, Rebekah Burns, Marc Auerbach, Derya Caglar, Kimberly Stone, Jennifer Reid

Affiliations

  1. Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine.
  2. Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital.
  3. Pediatric Resident, Seattle Children's Hospital.
  4. Pediatric Resident, University of Washington School of Medicine.
  5. Associate Professor of Pediatric Emergency Medicine and Emergency Medicine, Department of Pediatrics, Yale School of Medicine.
  6. Associate Professor of Pediatric Emergency Medicine and Emergency Medicine, Department of Pediatrics, Yale-New Haven Children's Hospital.
  7. Associate Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital.
  8. Co-Director of Pediatric Emergency Medicine Simulation, Seattle Children's Hospital.
  9. Associate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine.

PMID: 30800844 PMCID: PMC6338133 DOI: 10.15766/mep_2374-8265.10643

Abstract

INTRODUCTION: Submersion injury or drowning is a leading preventable cause of pediatric mortality and morbidity. Submersion injuries are often accompanied by hypothermia and asphyxia that can lead to inadequate oxygen delivery to tissues and subsequent cardiac arrhythmias.

METHODS: This simulation-based curriculum involves the identification and management of a submersion injury in a 4-year-old boy who was rescued from a cold-water submersion. The simulated patient is apneic, pulseless, bradycardic, and hypothermic; he is being bag-mask ventilated on arrival without intravenous access. He ultimately develops ventricular fibrillation. Providers must recognize the degree of submersion injury, initiate early airway protection, adequately address circulation, and be alert to developing hypothermia and cardiac arrhythmias to prevent further decompensation. This scenario can be modified based on trainee level (pediatric residents vs. pediatric emergency medicine fellows).

RESULTS: A total of 22 trainees (PGY 1-PGY 6 pediatric residents and pediatric emergency medicine fellows) participated in this simulation curriculum on separate occasions and rated it as an overall positive learning experience. The curriculum's goal is to provide learners with an opportunity to manage life-threatening pediatric submersion injuries, where the correct steps need to be taken in a limited period of time.

DISCUSSION: We have provided preparatory materials to help instructors set up, run, and debrief the scenario in a standardized fashion. The debriefing tools allow for adaptation depending on learners' needs and individual experiences during the simulated scenario. Also included are supporting educational materials and a learner feedback form that can be used to evaluate the session.

Keywords: Drowning; Hypothermia; Immersion; Pediatric Emergency Medicine; Simulation; Submersion; Ventricular Fibrillation

Conflict of interest statement

None to report.

References

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  2. Bull World Health Organ. 2005 Nov;83(11):853-6 - PubMed
  3. Circulation. 2010 Nov 2;122(18 Suppl 3):S829-61 - PubMed
  4. N Engl J Med. 2012 May 31;366(22):2102-10 - PubMed

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