B. Patient Profile and History Patient Name: Shelley Age: 29 Weight: 60 Gender: M F Code Status: Full Scenario States, Modifiers and Triggers Chief Complaint: Confusion/Vomiting/Diarrhea Patient History State of Presenting Illness: Patient Pt Status unable to Learner give history. Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Drowsy. Learner Actions Modifiers Changes to patient condition based on Moaning. From Rhythm: boyfriend: sinus Pt is 10 weeks pregnant. - History She started & physical having vomiting and diarrhea yesterday evening. learner action Laboured She tachycardia thinks she saw some streaks of blood - in Monitors her diarrhea. O2 applied O2 SAT 96% breathing. HR: 130/min - Ask for med list BP: Explains 90/60 that they had an argument yesterday - Apply because O2 they have been stressed over this unplanned and Triggers RR: unwanted 28/min pregnancy. They don’t live together. - 2nd He PIV left after lunch. For progression to next state She called at night to tell him she had vomiting and diarrhea, but told him not to come over because she was still upset. He came over to see how she was this morning. When he found her in bed, lethargic and confused, he called EMS. She did not complain of dysuria, frequency, fever. She noticed no vaginal bleeding. She had used alcohol and marijuana in the past but none in the last 4 weeks since she learned she was pregnant. Has been taking Prozac and a prenatal vitamin daily. Past Medical History: Anxiety/depression Medications: Fluoxetine Irritable bowel Pre-natal vitamins syndrome 1st trimester pregnancy Allergies: PCN C. Baseline Simulator State and Physical Exam No Monitor Display Monitor On, no data displayed Monitor on Standard Display HR: 130/min BP: 95/60 RR: 30/min O2SAT: 94% RA Rhythm: Sinus tach T: 37oC Glucose: 17.5 mmol/L GCS: 9 (E2 V2 M5) General Status: Toxic and unwell CNS: Lethargic and moaning. PERL 3mm. CVS: Tachycardic, heart sounds normal. RESP: Tachypneic, breath sounds normal. ABDO: Diffuse tenderness, no rigidity or guarding. MSK: Nil. SKIN: Scattered bruises
B. Patient Profile and History Patient Name: Shelley Age: 29 Weight: 60 Gender: M F Code Status: Full Chief Complaint: Confusion/Vomiting/Diarrhea History of Presenting Illness: Pt unable to give history. From boyfriend: Pt is 10 weeks pregnant. She started having vomiting and diarrhea yesterday evening. She thinks she saw some streaks of blood in her diarrhea. Explains that they had an argument yesterday because they have been stressed over this unplanned and unwanted pregnancy. They don’t live together. He left after lunch. She called at night to tell him she had vomiting and diarrhea, but told him not to come over because she was still upset. He came over to see how she was this morning. When he found her in bed, lethargic and confused, he called EMS. She did not complain of dysuria, frequency, fever. She noticed no vaginal bleeding. She had used alcohol and marijuana in the past but none in the last 4 weeks since she learned she was pregnant. Has been taking Prozac and a prenatal vitamin daily. Past Medical History: Anxiety/depression Medications: Fluoxetine Irritable bowel syndrome Pre-natal vitamins 1st trimester pregnancy Allergies: PCN C. Baseline Simulator State and Physical Exam No Monitor Display Monitor On, no data displayed Monitor on Standard Display HR: 130/min BP: 95/60 RR: 30/min O2SAT: 94% RA Rhythm: Sinus tach T: 37oC Glucose: 17.5 mmol/L GCS: 9 (E2 V2 M5) General Status: Toxic and unwell CNS: Lethargic and moaning. PERL 3mm. CVS: Tachycardic, heart sounds normal. RESP: Tachypneic, breath sounds normal. ABDO: Diffuse tenderness, no rigidity or guarding. MSK: Nil. SKIN: Scattered bruises Scenario States, Modifiers and Triggers Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Baseline State Rhythm: sinus tachycardia HR: 130/min BP: 90/60 RR: 28/min Drowsy. Moaning. Laboured breathing. Learner Actions - History & physical - Monitors - Ask for med list - Apply O2 - 2nd PIV Modifiers Changes to patient condition based on learner action O2 applied O2 SAT 96% Triggers For progression to next state
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