“Red in the Face” Interprofessional Simulation Case Scenario

Abstract

Abstract Red in the Face is a human patient simulation interprofessional case scenario applicable for medical students, nursing students, new residents, or new graduate nurses. In the scenario, the patient experiences red-man syndrome from rapid intravenous vancomycin infusion. The participants are expected to recognize signs and symptoms of red man syndrome, prioritize treatment modalities, implement the treatments collaboratively, and communicate interprofessionally using crew resource management principles. The faculty should be familiar with the scenario branch points. The faculty should be prepared to discuss: red man syndrome as one of the potential adverse effects of rapid vancomycin intravenous administration; differential diagnosis, the etiology, signs and symptoms of red-man syndrome; appropriate treatment modalities for this adverse effect, differences between red man syndrome and anaphylaxis, as well as using SBAR (Situation, Background, Assessment, Recommendation) and closed-loop communication among interdisciplinary health care team members. Since this scenario is designed for interprofessional learners, faculty from each discipline should be present at the scenario as well as the debriefing. This scenario was initially used with nursing students during a simulation competition. The students quickly identified an allergic-type reaction and during debriefing discovered the cause of the symptoms they recognized. Approximately 10 nursing students participated in the scenario and an additional 10 observed the scenario in real-time. Responses to a follow-up survey indicated that the scenario was clinically relevant to the nursing student population. This scenario was additionally tested with an interdisciplinary care team, including paramedics and physicians. The pilot test revealed that the scenario was clinically accurate, and the teaching points associated with distinguishing red-man syndrome from anaphylaxis and the appropriate treatment was relevant to a varying group of clinicians. The pilot group thought the scenario would be useful to train medical and nursing students as it is provides a comprehensive acute scenario for an interdisciplinary group to work together to treat, while taking into account their limited knowledge base. Evaluation survey from participants indicated that the scenario objectives and contents were relevant and interesting to the nursing students' population.

Keywords

• Anaphylaxis
• SBAR
• Histamine
• Vancomycin
• Red Man Syndrome
• Exfoliative Dermatitis