Assistant Professor of Clinical Pediatrics, Department of Pediatric Emergency Medicine, Yale University School of Medicine.
Pediatric Emergency Medicine Fellow, Departments of Emergency Medicine and Pediatrics, Warren Alpert Medical School of Brown University and Hasbro Children's Hospital/Rhode Island Hospital.
MedEdPORTAL. 2020 Sep 10;16:10967. doi: 10.15766/mep_2374-8265.10967.
Thyroid storm is a rare but life-threatening disease process that may be difficult to recognize and mimics other disease processes. It is critical for the emergency medicine clinician to be able to recognize thyroid storm in patients in order to effectively stabilize and treat them.
In this standardized patient case, learners were faced with a 17-year-old postpartum woman presenting to the emergency department with respiratory distress and altered mental status secondary to thyroid storm. The target learners were emergency department providers, including residents, medical students, and advanced practice practitioners. Providers were expected to identify signs and symptoms of thyroid storm and to initiate appropriate diagnostic workup and management of this complex patient. Debriefing followed the simulation using a debriefing guide and PowerPoint presentation.
Thirty-four learners participated in this simulation. All learners agreed or strongly agreed that the simulation case was relevant to their work, and 97% agreed or strongly agreed that it was effective in teaching thyroid storm management skills. Eighty-five percent felt that following the simulation, they would be confident in their ability to recognize thyroid storm in a postpartum patient and to recognize and manage respiratory distress and altered mental status in a postpartum patient.
Learners felt that this case was effective in teaching the skills necessary for caring for postpartum patients with respiratory distress and altered mental status. Future directions include conducting the simulation in situ to include multidisciplinary teams and increasing the learner pool to include OB/GYN residents.
甲状腺危象是一种罕见但危及生命的疾病过程，可能难以识别，并模仿其他疾病过程。对于急诊医学临床医生来说，能够识别甲状腺危象患者非常重要，以便能够有效地稳定和治疗他们。
在这个标准化患者病例中，学习者面对的是一名 17 岁的产后妇女，因甲状腺危象导致呼吸窘迫和意识改变而到急诊就诊。目标学习者是急诊提供者，包括住院医师、医学生和高级执业医师。提供者应识别甲状腺危象的迹象和症状，并启动适当的诊断性检查和这种复杂患者的管理。模拟后使用辅导指南和 PowerPoint 演示进行辅导。
34 名学习者参加了此次模拟。所有学习者都同意或强烈同意该模拟病例与他们的工作相关，97%的学习者同意或强烈同意该模拟病例在教授甲状腺危象管理技能方面非常有效。85%的学习者表示，模拟后，他们对自己在产后患者中识别甲状腺危象的能力，以及在产后患者中识别和管理呼吸窘迫和意识改变的能力有信心。
学习者认为这个病例在教授照顾有呼吸窘迫和意识改变的产后患者的技能方面非常有效。未来的方向包括在现场进行模拟，包括多学科团队，并增加学习者群体，包括妇产科住院医师。
