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面向初级保健提供者的儿科模拟病例:办公室中的哮喘、过敏反应、癫痫发作

Pediatric Simulation Cases for Primary Care Providers: Asthma, Anaphylaxis, Seizure in the Office.

作者信息

Sanseau Elizabeth, Reid Jennifer, Stone Kimberly, Burns Rebekah, Uspal Neil

机构信息

Adjunct Clinical Professor, Department of Pediatrics, University of Washington School of Medicine.

Adjunct Clinical Professor, Department of Pediatrics, Seattle Children's Hospital.

出版信息

MedEdPORTAL. 2018 Oct 5;14:10762. doi: 10.15766/mep_2374-8265.10762.

Abstract

INTRODUCTION

Although pediatric emergencies commonly occur in the outpatient setting, studies show that primary care providers often rely on hospitals or the emergency medical system to evaluate the distressed patient. This simulation-based curriculum addresses pediatric emergencies encountered by primary care providers. The cases were facilitated by faculty at an annual conference on urgent pediatric problems.

METHODS

Three cases are included in this curriculum: asthma, anaphylaxis, and seizure. Each features a brief narrative description of the case, learning objectives, instructor notes, an example of the ideal flow of the scenario, and anticipated management mistakes. Also provided are tools on optimizing the simulation environment, teamwork and communication, and the debrief. Educational materials are included in the respective medical pathologies. The simulations can be run using a high- or low-fidelity mannequin.

RESULTS

The simulations were carried out annually for 4 years with over 100 providers. Participants overall felt the curriculum was relevant to their practice in the realms of medical management and patient-provider communication.

DISCUSSION

These simulation cases train primary care providers to recognize a decompensating patient, activate the emergency response system, and initiate appropriate treatment for acutely ill pediatric patients with asthma, anaphylaxis, or seizure. The cases also reinforce teamwork and communication skills with the intention of improving overall readiness in the office. The simulations have been found to be effective learning tools at the University of Washington, which continues to train outpatient providers in emergency response annually using this curriculum.

摘要

引言

尽管儿科急症通常发生在门诊环境中,但研究表明,初级保健提供者常常依赖医院或紧急医疗系统来评估病情危急的患者。这一基于模拟的课程涉及初级保健提供者遇到的儿科急症。这些病例由一次关于儿科急症问题的年度会议上的教员进行讲解。

方法

本课程包含三个病例:哮喘、过敏反应和癫痫发作。每个病例都有病例的简短叙述、学习目标、教员注释、情景理想流程示例以及预期的管理失误。还提供了优化模拟环境、团队协作与沟通以及总结汇报方面的工具。教育材料包含在各自的医学病症内容中。模拟可以使用高保真或低保真人体模型进行。

结果

该模拟每年进行一次,持续了4年,有超过100名提供者参与。总体而言,参与者认为该课程在医疗管理和医患沟通领域与他们的实践相关。

讨论

这些模拟病例培训初级保健提供者识别病情恶化的患者、启动应急响应系统,并对患有哮喘、过敏反应或癫痫发作的急性病儿科患者进行适当治疗。这些病例还强化了团队协作和沟通技巧,旨在提高诊所的整体应急准备能力。在华盛顿大学,这些模拟已被证明是有效的学习工具,该校继续每年使用这一课程培训门诊提供者的应急响应能力。

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