Fellow, Department of General Pediatrics, Division of Emergency Medicine, Children's Hospital of Philadelphia.
Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington; Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital.
MedEdPORTAL. 2020 May 15;16:10900. doi: 10.15766/mep_2374-8265.10900.
Wilderness recreation is increasingly popular among people of all ages. Pediatric providers should have the skills to counsel on risk reduction and respond to medical emergencies in remote settings. However, few physicians receive training in wilderness medicine, and this simulation-based curriculum aims to address that gap.
The scenario features an adolescent male in a remote setting with hypothermia, dehydration, and an ankle injury. The simulation is not resource intensive, utilizing a simulated patient actor and minimal equipment. The case includes a case description, learning objectives, instructor notes, example of ideal scenario flow, and anticipated management mistakes. A didactic PowerPoint highlighting the learning objectives is included.
The simulation was carried out over 1 year in various settings, including urban parks, the wilderness, and the classroom, with 35 medical trainees. Thirty participants (11 medical students, eight residents, and 11 fellows) completed postsimulation surveys; more than 86% gave the highest score of 5 (strongly agree) when asked if the simulation improved their understanding of managing hypothermia, dehydration, and ankle injury in the wilderness.
This simulation case trains responders to recognize an injured hiker; activate the emergency response system; initiate appropriate treatment for hypothermia, dehydration, and an ankle injury; and stabilize for transport. It reinforces medical conditions unique to the wilderness, improvisation in managing medical issues outside of the usual health care environment, and teamwork/communication skills. This case has been found to be an effective learning tool for medical students, residents, and fellow physicians alike.
荒野娱乐在各个年龄段的人群中越来越受欢迎。儿科医生应该具备降低风险的技能，并能够在偏远地区应对医疗紧急情况。然而，很少有医生接受过荒野医学培训，本基于模拟的课程旨在填补这一空白。
该情景的特点是一名青少年男性在偏远地区出现体温过低、脱水和踝关节受伤。该模拟不需要大量资源，仅利用模拟患者演员和最少的设备。该病例包括病例描述、学习目标、教师说明、理想情景流程示例和预期管理错误。还包括一个突出学习目标的演示文稿。
该模拟在不同环境中进行了一年，包括城市公园、荒野和教室，共有 35 名医学学员参与。30 名参与者（11 名医学生、8 名住院医师和 11 名研究员）完成了模拟后调查；当被问及模拟是否提高了他们对荒野中管理体温过低、脱水和踝关节损伤的理解时，超过 86%的人给出了最高分 5（非常同意）。
该模拟病例培训急救人员识别受伤的徒步旅行者；启动紧急响应系统；对体温过低、脱水和踝关节损伤进行适当的治疗；并稳定后进行转运。它强化了荒野中独特的医疗状况、在通常的医疗环境之外处理医疗问题的即兴能力以及团队合作/沟通技巧。事实证明，该病例对于医学生、住院医师和研究员都是一种有效的学习工具。
