Emergency Medicine Pre-Code Scenario: Theophylline Overdose

Abstract

Abstract Accidental poisoning and drug overdose are a common occurrence in the emergency medicine setting. Often, it is unknown what substances the patient has taken. This high-fidelity simulation focuses on developing a medical learner's clinical exam and clinical reasoning skills. By using the evidence given in the simulation, the medical learner can deduce that this is a case of theophylline poisoning and, once discovering the source, use medical knowledge skills to treat the underlying condition and all the complications. A clinical educator can use this simulation to test a number of learners at various levels of education (student, intern, senior resident, fellow). The simulation focuses on medical knowledge, physical exam, and clinical reasoning skills and is a live simulation, so medical decisions are made in real time and affect the patient outcome. Through this simulation, the realism of a clinical toxicology case is set in motion and is an excellent form of education for many learners who will be in this real setting in the future. This case is currently in use at Mayo Clinic in Florida for clinical reasoning and medical knowledge training. The scenario has been used successfully over the past 2 years and is the result of recursive development and experience of the authors during this period. The scenario utilizes a standardized patient who presents with tachycardia, nausea, and vomiting. The case includes several branches from least complex to most complex and may progress, at the discretion of the instructor, up to the point of a full code. In addition to details required for setting up and managing the scenario and branches, this resource also includes robust debriefing materials.

Keywords

• Emergencies
• Overdose
• Seizures
• Arrhythmias
• Cardiac
• Theophylline