Ectopic Pregnancy: A Case for High-Fidelity Simulation in Emergency Medicine

Abstract

Abstract This educational resource provides the information and materials for a high-fidelity simulation case suitable for medical students and resident physicians in emergency medicine. The case involves a young woman who presents with syncope and abdominal pain. A pregnancy test in the emergency department is positive, which is a concerning finding for this patient, who has had a tubal ligation. She is hypotensive and tachycardic, with a bedside ultrasound significant for intra-abdominal free fluid and a possible left-sided ectopic pregnancy. Appropriate treatment includes fluid resuscitation, obstetrical consultation, blood transfusion if necessary, and disposition to the operating room for a presumed ruptured ectopic pregnancy. Debriefing materials are provided to illustrate and stimulate discussion of the important concepts for diagnosing and treating patients with ectopic pregnancy. The case is currently in use at our institution for upper-level emergency medicine residents completing required educational time in our Emergency Department Simulation Program. The case has been used for the past 3 years in our program and has recently been edited and expanded to its existing form. This scenario has been presented for small groups of three to four participants and has been field-tested approximately six times in the last 3 years. All participants have been PGY1, PGY2, and PGY3 emergency medicine residents.

Keywords

• Abdominal Pain
• Ectopic Pregnancy
• Syncope
• Hypotension
• Tachycardia
• Pregnancy Complications