Surviving Simulated Sepsis

This is an educational resource intended to provide the information and materials necessary to run an original simulated case suitable for training small to medium-sized groups of medical students and residents. This case is one of several designed by the staff of the Uniformed Services University in collaboration with staff from Walter Reed Army Medical Center, and is currently in use at the Walter Reed Medical Simulation Center. This simulated case involves a patient presenting to the emergency department (ED) with signs and symptoms consistent with systemic inflammatory response syndrome (SIRS). The trainee is responsible for proper assessment, diagnosis, and management as the patient progresses from SIRS to sepsis, severe sepsis, and ultimately septic shock. Pauses for discussion are interspersed throughout the scenario, typically after important decision points, to illustrate and emphasize key learning objectives. Short slide sets are included with the case to facilitate these discussions. Surviving Simulated Sepsis Hemann BA, Mikita JA, Hall NM I. TITLE: “Surviving Simulated Sepsis” II. AUDIENCE: Medical students and resident physicians III. LEARNING OBJECTIVES: A. Primary Learning Objectives. 1. List the criteria for the diagnosis of SIRS, sepsis, severe sepsis and septic shock. 2. Demonstrate a guidelines-based approach to the management of a patient with severe sepsis or septic shock 3. Define early goal directed therapy 4. Demonstrate proper use of vasopressors 5. Outline principles of initial antibiotic coverage B. Secondary Goals 1. Outline the pathophysiology of septic shock. 2. Articulate the clinical importance of determining bacterial species and site of infection. C. Critical Actions 1. Obtain pertinent history and perform appropriate physical examination. 2. Systematically assess airway, breathing, and circulation. 3. Order appropriate laboratory studies, radiographic imaging, etc. 4. Interpret lab results, chest x-ray, and electrocardiogram 5. Identify unstable vital signs and symptoms. 6. Administer early goal directed therapy. 7. Utilize appropriate vasopressors to treat refractory hypotension. 8. Perform brief sign-out during patient turnover to new team. 9. Complete admission order writing exercise.