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MedEdPORTAL. 2019 Oct 25;15:10846. doi: 10.15766/mep_2374-8265.10846.

Pediatric Toxidrome Simulation Curriculum: Bupropion Overdose.

MedEdPORTAL : the journal of teaching and learning resources

Emily Hartford, Anita Thomas, Ashley Keilman, Neil Uspal, Kimberly Stone, Jennifer Reid, Rebekah Burns

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. Associate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine.
  4. Associate Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital.

PMID: 31921992 PMCID: PMC6946581 DOI: 10.15766/mep_2374-8265.10846

Abstract

INTRODUCTION: Bupropion is a commonly used antidepressant, and overdose can lead to both neurologic and cardiovascular toxicity, including agitation, seizure, tachycardia, QT and QRS prolongation, and rhythm disturbances.

METHODS: We developed this simulation case for attendings, fellows, nurse practitioners, and nurses in the pediatric emergency department (ED). The scenario involved a 13-year-old male presenting to the ED with altered mental status and a generalized tonic-clonic seizure shortly after arrival. The team needed to quickly perform primary and secondary surveys, manage his airway and breathing, and initiate treatment for seizure. The team had to obtain an abbreviated history and include ingestion in the differential. The patient then developed pulseless ventricular tachycardia, and the team needed to respond with high-quality CPR, defibrillation, and advanced airway management. Preparatory materials, a debriefing guide, and scenario evaluation forms assisted with facilitation.

RESULTS: Twenty-eight physicians, 56 nurses, 10 nurse practitioners, four pharmacists, two students, and one respiratory therapist completed this simulation in 13 sessions. On a 5-point Likert scale, participants agreed with the stated objective of ability to manage a patient with a bupropion overdose (

DISCUSSION: This scenario is a complete educational resource for setting up, implementing, and debriefing in an interprofessional setting. It was well received by learners from diverse professional backgrounds working together in actual care teams in the pediatric ED.

Copyright © 2019 Hartford et al.

Keywords: Bupropion Overdose; Emergency Medicine; Medical Toxicology; Seizure; Simulation; Toxidrome; Ventricular Tachycardia

Conflict of interest statement

None to report.

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