SimBox+

Facilitate the Tabletop Simulation using the
“Discussion & Do Guide”

 

 Tabletop Simulations consist of a:

• Scenario

• Discussion & Do Guide

• Video link if applicable for skills practice  

 

As facilitator you will be asked to read aloud a scenario to the team. In some cases, there may be a photo to share with the team. 

• The scenarios are focused with specific exam and clinical findings

• Please do not make up extra information for the team. As in real life, the information you may have about the patient is what you must work with. 

 

Example Scenario

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​Anaphylaxis:

 

A 2-year-old presents with difficulty breathing. 

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On arrival you find out the child has known nut allergies and was playing at the neighbor's house where he had a granola bar for snack about 15 minutes ago. The child quickly developed hives and difficulty breathing.  

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Exam: The child is pale and anxious with vomit on their shirt, hives, and is coughing frequently with subcostal retractions and tachypnea. 

 

After reading the scenario, you’ll follow the Discussion & Do Guide

 

Each Discussion & Do Guide will follow a similar format. As facilitator you will ask the team the questions presented.

• You may receive a lot of different answers. There might be team discussion around other interventions.

• The answers highlighted in red are the highest priority intervention, medication or piece of equipment needed.

• Text in green indicates that you are asking the team to DO something like finding and touching equipment or performing a skill. 

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Example Discussion and Do Guide: Anaphylaxis

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1. Use your pediatric assessment triangle: Sick or not sick? 

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2. What is your primary concern for this child: Anaphylaxis

Why?: 2 systems involved, severe symptom with work of breathing

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3. What medication or equipment do you want for this child? IM Epinephrine! (Here you might get a lot of answers such as monitors, IV access, Benadryl etc, but the most important treatment intervention for Anaphylaxis is IM Epinephrine). 

 

4. How do you know the right size of equipment or medication dosing for this patient? (have the team measure the mannequin) Give weight of 10kg or 2yo.

• Find and touch the equipment you need to give IM epi. 

[ ] Epinephrine medication

[ ] 3-way stopcock

[ ] 1mL

[ ] 3mL syringe 

• How do you know how much medication to give? 0.1mg = 0.1mL of epinephrine

Can you show me? 

• Draw up the epinephrine dose for this patient: 

How do you give it? IM

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​5. What are your next priorities for this patient? Reassess, 2nd dose epi ready, access​

• Touch the equipment you might need:

[ ] face mask

[ ] oxygen

[ ] IV access

[ ] IO access

[ ] NS or LR bolus benadryl

[ ] 2nd epi dose etc

[ ] albuterol

[ ] steroids

[ ] racemic epi (Identify what is part of YOUR protocol or clinical pathway, where is this information located?)  

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When appropriate there may be brief videos or links that may provide additional case specific educational resources, clinical care guidelines, or policies/protocols. 

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As you can see these cases are brief. They are designed to get the team thinking about important interventions, equipment location, and using a medication reference and practicing one specific skill. These cases are not meant to be comprehensive.    

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Facilitator Tips: You can prompt you team with statements like:

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• “Can you show me where you found the appropriate size equipment for the patient OR the medication dose for this patient”.  Have a team member show you the resources they are using.

 

• If the team is not considering a piece of equipment, you can ask them directly to find it.

 

• It’s OK to ask you team to prioritize their interventions for the patient.

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       Watch a team run a Tabletop Simulation: (video link) Coming soon!