Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Hypotensive Learner Actions Modifiers Rhythm: SR - Initiate IV access, monitors, Changes to patient condition based on learner action HR: 108/min labs, ECG, pCXR - Crystalloid bolus HR 106 and BP: 88/52 - Perform an initial history and BP 100/54 RR: 28/min physical exam being careful to O2SAT: 97% gain all relevant details Triggers T: 36.4oC - Communicate with the patient For progression to next state who is completely awake - All actions completed or 5 - Administer cautious fluid bolus minutes elapsed 2. Diagnosis (500mL RL or NS IV) 2. Diagnosis Apprehensive Learner Actions Modifiers Rhythm: SR about - Interpret ECG and pCXR - RN to prompt consultation if HR: 108/min procedure - Perform POCUS and recognize asked for pericardiocentesis kit BP: 100/54 pericardial effusion RR: 28/min - Vocalize working diagnosis Triggers O2SAT: 97% - Call ICU, cardiology and/or - All actions completed or 5 T: 36.4oC cardiac/thoracic surgery minutes elapsed consultations 3. Consultation 3. Consultation Stable Learner Actions Modifiers Rhythm: SR - Introduce self and rank to HR: 106/min consultant Triggers BP: 100/54 - Give “one-liner” summary of - End of case after consultation RR: 28/min patient O2SAT: 97% - Ask core clinical question T: 36.4oC - Collaborate with consultant on care plan including re-iteration of timing of consultation - Close the loop and summarize the plan **These actions may vary depending on which consultation model you use (5C, PIQUED, CONSULT, etc) Section VI: Scenario Progression Section VII: Supporting Documents, Laboratory Results, & Multimedia
Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Rhythm: SR HR: 108/min BP: 88/52 RR: 28/min O2SAT: 97% T: 36.4oC Hypotensive Learner Actions - Initiate IV access, monitors, labs, ECG, pCXR - Perform an initial history and physical exam being careful to gain all relevant details - Communicate with the patient who is completely awake - Administer cautious fluid bolus (500mL RL or NS IV) Modifiers Changes to patient condition based on learner action - Crystalloid bolus HR 106 and BP 100/54 Triggers For progression to next state - All actions completed or 5 minutes elapsed 2. Diagnosis 2. Diagnosis Rhythm: SR HR: 108/min BP: 100/54 RR: 28/min O2SAT: 97% T: 36.4oC Apprehensive about procedure Learner Actions - Interpret ECG and pCXR - Perform POCUS and recognize pericardial effusion - Vocalize working diagnosis - Call ICU, cardiology and/or cardiac/thoracic surgery consultations Modifiers - RN to prompt consultation if asked for pericardiocentesis kit Triggers - All actions completed or 5 minutes elapsed 3. Consultation 3. Consultation Rhythm: SR HR: 106/min BP: 100/54 RR: 28/min O2SAT: 97% T: 36.4oC Stable Learner Actions - Introduce self and rank to consultant - Give “one-liner” summary of patient - Ask core clinical question - Collaborate with consultant on care plan including re-iteration of timing of consultation - Close the loop and summarize the plan **These actions may vary depending on which consultation model you use (5C, PIQUED, CONSULT, etc) Modifiers Triggers - End of case after consultation Section VI: Scenario Progression Section VII: Supporting Documents, Laboratory Results, & Multimedia