Initial Resuscitation of a Multisystem Trauma Patient Following a Fall From Height: A Complete Simulation Scenario for Medical Students.

Maxwell J Jabaay,Leah O Grcevich,James Lyons,Benjamin T Leicht

doi:10.7759/cureus.13013

Maxwell J Jabaay, Leah O Grcevich + Show 2 more

Open Access

https://doi.org/10.7759/cureus.13013

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Journal: Cureus	Publication Date: Jan 30, 2021
Citations: 1	License type: cc-by

Affiliation: Alabama College of Osteopathic Medicine

Abstract

Management of a complex trauma patient is a critical skill for medical students, particularly during a general surgery or emergency medicine clerkship. However, gaining proficiency with this skillset may be challenging without prior medical or simulation experience. The aim of this technical report is to present a comprehensive high-fidelity medical simulation of a polytraumatized patient with numerous injuries sustained from a 20-foot fall. As the scenario unfolds, students identify multisystem injuries including acute hemorrhage, femur fracture, tension pneumothorax, and traumatic brain injury. The case was designed as an assessment tool to evaluate the knowledge of preclinical medical students obtained through a one-day workshop on the primary survey. This technical report provides simulation designers with a premade script, flowchart, labs, images, and supplies needed to successfully recreate the case.

Highlights

Traumatic injury represents a significant public health concern in the United States, with 20 million traumarelated discharges annually, representing 4.4% of all-cause hospital discharges between 2000 and 2011 [1]
The intended audience was preclinical medical students but could be adapted to include higher level providers with some additions to the case. This case was run in a medical school simulation center as if the patient was just transferred to an emergency department (ED) trauma bay from emergency medical services (EMS)
In order to mirror the environment (ED) in which the skill being taught would be practiced, careful consideration was given to the team-based approach for trauma patients; this includes pre-hospital EMS, ED trauma teams as well as definitive care providers such as surgical and intensive care teams

Summary

Introduction

Traumatic injury represents a significant public health concern in the United States, with 20 million traumarelated discharges annually, representing 4.4% of all-cause hospital discharges between 2000 and 2011 [1]. The following simulation scenario involves the management of a multisystem trauma patient whose injuries were incurred following a fall from 20 feet. This scenario was originally developed as an assessment tool for a comprehensive one-day curriculum, in which medical students were instructed on how to perform the primary survey [7]. The intended audience was preclinical medical students but could be adapted to include higher level providers with some additions to the case This case was run in a medical school simulation center as if the patient was just transferred to an emergency department (ED) trauma bay from emergency medical services (EMS). Prop open femur fracture (Figure 1B) with an attached prop blood bag filled with fake blood (see Appendix D)

Training tourniquet or gauze

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