Simulation based learning in severe acute pancreatitis : A tool for teaching and training

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2017-09, Vol.17 (4), p.S44-S44
• Main Authors: Morioka, Cintia, Pereira, Nixon Alves, Veiga da Silva, Joelmir, Costa, Alessandro Ramon Salem Costa, Garcia, Marcelo Engracia, Otoch, Jose Pinhata, Borges, Gustavo, Lima, Edgard Mesquita Rodrigues
• Format: Article
• Language: English
• Subjects: Emergency medical care; Hypocalcemia; Intensive care; Pancreatitis; Simulation
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2017.07.144

Method: SimMan® at Interdisciplinar Center for Simulation (NIS),University Nove de Julho,was used.A male flight attendant,35 y.o.,was brought to ER,complaining of deep epigastric pain with radiation to the back,nausea,vomiting (12 episodes in 6 hours),weakness after a barbecue party.He has drunk 3 liters of beer.He was not urinating. Results: Students should ask for blood exams,arterial blood gas analysis,abdominal X-Ray,CT,and US.After informed about leucocytosis (>16,000 ul), hyperglycemia, LDH over 350 u/L,AST>250 u/L,hypocalcemia,elevated serum bilirubin,elevated BUN and CT showing an enlarged pancreas with areas of necrotizing pancreatitis.After diagnosis of acute pancreatitis,they should choose chips of oxygen mask,calcium,antipyretics,saline solution,antiemetics and antibiotics.They should place a nasogastric tube and intravesical catheter.They should also provide a central vein access.These last three habilities have been trained through the medical course in early stages.They should provide the transference to an Intensive Care Unit.They should discuss about the possibility of endotracheal intubation if the patient evaluates to shock or sepsis.Moreover,they should state about the follow up according to Ransom’s criteria.