Scenario States, Modifiers and Triggers Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Confused, Learner Actions Modifiers Rhythm: Sinus tach complains of - Place on monitors Changes to patient condition based on learner action HR: 120/min chest pain - Listen to EMS - EMS handover finishes BP: 110/65 - Place 2nd IV line + BW Charting RN enters RR: 28/min - Start crystalloid O2SAT: 92% (NRB) - Call for blood products Triggers T: 36.6oC - Primary survey For progression to next state - FAST - All actions complete or 5 min into - Provide analgesia case 2. Hypoxia - Call for portable CXR, PXR - Cap glucose 2. Hypoxia Becoming Learner Actions Modifiers Rhythm: Sinus tach agitated - Communicate situation to - Start of state Anesthesia HR: 125/min anesthesia enters BP: 110/65 - Prepare for intubation - Attempt chest tube placement RR: 28/min - Prepare for chest tube patient becomes agitated O2SAT: 86% (NRB) Triggers - Intubation 3. Hypotension 3. Hypotension Intubated Learner Actions Modifiers Rhythm: Sinus tach - Communicate situation to TTL - Start of state TTL enters HR: 110/min - Needle or finger - Chest tube placed O2SAT=96% BP: 75/50 thoracostomy RR: 12/min - Place chest tube Triggers O2SAT: 90% (ETT) - Blood products - Chest tube placed and blood - TXA products started 4. Resolution 4. Resolution Intubated Learner Actions Modifiers Rhythm: Sinus tach - Post intubation sedation HR: 110/min - Call CT BP: 90/65 - Call ICU Triggers RR: 12/min - Call CT End Case O2SAT: 96% (ETT) Section VII: Supporting Documents, Laboratory Results, & Multimedia
Scenario States, Modifiers and Triggers Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Rhythm: Sinus tach HR: 120/min BP: 110/65 RR: 28/min O2SAT: 92% (NRB) T: 36.6oC Confused, complains of chest pain Learner Actions - Place on monitors - Listen to EMS - Place 2nd IV line + BW - Start crystalloid - Call for blood products - Primary survey - FAST - Provide analgesia - Call for portable CXR, PXR - Cap glucose Modifiers Changes to patient condition based on learner action - EMS handover finishes Charting RN enters Triggers For progression to next state - All actions complete or 5 min into case 2. Hypoxia 2. Hypoxia Rhythm: Sinus tach HR: 125/min BP: 110/65 RR: 28/min O2SAT: 86% (NRB) Becoming agitated Learner Actions - Communicate situation to anesthesia - Prepare for intubation - Prepare for chest tube Modifiers - Start of state Anesthesia enters - Attempt chest tube placement patient becomes agitated Triggers - Intubation 3. Hypotension 3. Hypotension Rhythm: Sinus tach HR: 110/min BP: 75/50 RR: 12/min O2SAT: 90% (ETT) Intubated Learner Actions - Communicate situation to TTL - Needle or finger thoracostomy - Place chest tube - Blood products - TXA Modifiers - Start of state TTL enters - Chest tube placed O2SAT=96% Triggers - Chest tube placed and blood products started 4. Resolution 4. Resolution Rhythm: Sinus tach HR: 110/min BP: 90/65 RR: 12/min O2SAT: 96% (ETT) Intubated Learner Actions - Post intubation sedation - Call CT - Call ICU Modifiers Triggers - Call CT End Case Section VII: Supporting Documents, Laboratory Results, & Multimedia