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Autism De-escalation
Seventeen-year-old Alex Johnson has autism spectrum disorder (ASD). When he fell from his bike he sprained his wrist, requiring a splint. The unfamiliar emergency department at the hospital causes Alex to get anxious and overwhelmed. Verbal de-escalation must be applied to calm him.
Pediatric Intraosseous Infusion
Pediatric intraosseous infusion is initiated when vascular access is required emergently but is difficult to achieve via peripheral vain. Compared to adults, the level of care required is greater for pediatric patients.
Pediatric DKA
Anna is in the ED unwell with abdominal pain and vomiting. She has received a 20cc/kg bolus for initial hypotension and an insulin bolus of 8 units. EMS lost the IV en route, and the patient is now more somnolent in the ED.
Pediatric Anaphylaxis
Kevin, 7, is known to be allergic to peanuts. Ten minutes after eating a cake, he developed wheeze, shortness of breath and rash. His mother administered his epinephrine auto-injector and called EMS.
Pediatric Septic Shock
Olivia, 4, is in ED as she is lethargic and “not herself”. She has had a fever and cough for the past three days. On arrival she looks toxic, has delayed capillary refill, a glazed stare, tachypnea, and tachycardia.
Pediatric SVT
Jerry, a 12-month-old infant, and has been brought into the ED by his parents. He has been fussy, crying all night, not been feeding well, and vomited once. Jerry is found to have a significantly elevated heart rate.
Pediatric Bronchiolitis
Seven month old Tania’s older sibling developed a cold four days prior and next day Tania had a running nose and a cough. Yesterday she did not eat or drink much and this morning she had some noisy breathing.
Pediatric Asthma Exacerbation
Charlie Jansen, 7-year-old, has a known case of asthma. His three-days old cough is accompanied by wheezing and a worsening shortness of breath. The puffer is not helping and Charlie’s condition is getting worse.
IV Insertion and Removal
Clark, a 51-year-old male, requires an IV insertion as a pre-operative measure. As a nurse, your job is to place the IV correctly and as painlessly as possible. You will also have to remove the IV at the end of the treatment.
Staple Removal
Jennifer Brown is visiting the physician’s office for a staple removal procedure ten days after she had an excision of squamous cell carcinoma. The incision is three inches long with seven staples on the right lower leg.