QUICK

SOLUTION
GUIDE
SPINAL CORD INJURY WITH
NEUROGENIC SHOCK DUE TO AN
ACCIDENT

SCENARIO #172
NAME
THOMAS CARTER

SPECIALTY
Trauma

SCENARIO DIFFICULTY
INTERMEDIATE

SIMULATION ENVIRONMENT
EMERGENCY ROOM

TARGET
Medical

This patient is not a real patient and the clinical case, while clinically plausible, is fictional.
 Dialogues
Ask the following questions to the patient:

Medical condition
- How are you feeling right now?
- Are you feeling any pain?
- Do you have any allergies?
Medication
- Are you taking any medication?
Neurological evaluation
- Do you feel any tingling in your foot or leg?
- Can you move your legs?
- Can you feel your legs?
- Did you lose consciousness?

Physical examination
Perform the following physical examinations:

Airway
- Airway observation
Breathing
- Chest palpation
- O2 Sat (%)
- Pulmonary auscultation
- Respiratory rate (/min)
Circulation
- Blood pressure (mmHg)
- Heart auscultation
- Heart rate (bpm)
- Pulse palpation
Disability
- Glasgow Coma Scale
- Neurological test
- Pupil light reflex

© 2013-2022 TakeTheWind - CONFIDENTIAL 1 4 August 2022

 Exposure
- Abdominal palpation
- Rectal examination
- Spine palpation

Medical tests
Request the following medical tests:

Imaging
- Abdominal CT
- AP pelvis radiography
- Cervical spine CT
- Chest X-ray
- CT pulmonary angiogram
- FAST
- Head CT
- Pelvic CT
Lab tests
- Arterial blood gas
- Blood typing
- Complete blood count

Treatments
Administer the following treatments:

i.51. One of the following:

- Medications > Noradrenaline
- Medications > Dopamine
- Medications > Phenylephrine
i.53. One of the following:
- Interventions > Nasal cannula
- Interventions > High flow mask
- Interventions > Non-rebreathing mask
i.55

© 2013-2022 TakeTheWind - CONFIDENTIAL 2 4 August 2022

 - Interventions > Erythrocytes transfusion
i.56. One of the following:
- Interventions > IV peripheral catheter (R/L)
- Interventions > Central venous catheter introducer
i.57
- Interventions > Central venous catheter triple lumen (R/L)
i.58
- Interventions > Left lateral decubitus
Specialties' calls
- Call > Neurosurgery
Tomography. One of the following:
- Call > Tomography/CT room
- Call > Send to Tomography/CT room
i.62
- Call > Intensive care unit (ICU)

© 2013-2022 TakeTheWind - CONFIDENTIAL 3 4 August 2022

 Baseline
Visualize the baseline approach. The baseline predicts scenario behavior assuming no actions by the trainee, which usually
represents the worst-case scenario.

© 2013-2022 TakeTheWind - CONFIDENTIAL 4 4 August 2022

 Optimal approach
Visualize the optimal approach to end your simulation successfully.

© 2013-2022 TakeTheWind - CONFIDENTIAL 5 4 August 2022

 Differential diagnosis
Multiple choice question presented to the trainee in order to confirm whether they got the diagnosis right.

Summative question:

Question What is the most likely diagnosis?

Correct answer Spinal cord injury with neurogenic shock

3 Incorrect answers Hypovolemic shock

Heart failure

Spinal cord injury with cardiogenic shock

© 2013-2022 TakeTheWind - CONFIDENTIAL 6 4 August 2022

QUICK
SOLUTION
GUIDE
BLUNT TRAUMA WITHOUT
HEMODYNAMIC COMPROMISE DUE TO A
MOTORCYCLE ACCIDENT

SCENARIO #174
NAME
JOHN SMITH

SPECIALTY
Trauma

SCENARIO DIFFICULTY
INTERMEDIATE

SIMULATION ENVIRONMENT
EMERGENCY ROOM

TARGET
Medical

This patient is not a real patient and the clinical case, while clinically plausible, is fictional.
 Dialogues
Ask the following questions to the patient:

Medical condition
- How are you feeling?
- Do you feel breathless?
- Could you please tell us your age?
- Did you lose your senses?
- Do you have any allergies?
Medication
- Are you taking any medication?

Physical examination
Perform the following physical examinations:

Airway
- Airway observation
Breathing
- O2 Sat (%)
- Pulmonary auscultation
- Respiratory rate (/min)
Circulation
- Blood pressure (mmHg)
- Heart auscultation
- Heart rate (bpm)
- Pulse palpation
Disability
- Glasgow Coma Scale
- Pupil light reflex
Exposure
- Abdominal palpation

© 2013-2022 TakeTheWind - CONFIDENTIAL 1 4 August 2022

 Medical tests
Request the following medical tests:

Imaging
- Abdominal CT
- AP pelvis radiography
- Chest CT
- Chest X-ray
Lab tests
- Arterial blood gas
- Blood typing
- Complete blood count

Treatments
Administer the following treatments:

i.46. One of the following:

- Interventions > High flow mask
- Interventions > Nasal cannula
- Interventions > Non-rebreathing mask
i.47
- Interventions > Left chest drain
i.49. One of the following:
- Interventions > IV peripheral catheter (R/L)
- Interventions > Central venous catheter introducer
i.50
- Interventions > Erythrocytes transfusion
i.52
- Interventions > Left lateral decubitus
i.54
- Call > Intensive care unit (ICU)
i.55. One of the following:
- Call > Tomography/CT room
- Call > Send to Tomography/CT room

© 2013-2022 TakeTheWind - CONFIDENTIAL 2 4 August 2022

 Baseline
Visualize the baseline approach. The baseline predicts scenario behavior assuming no actions by the trainee, which usually
represents the worst-case scenario.

© 2013-2022 TakeTheWind - CONFIDENTIAL 3 4 August 2022

 Optimal approach
Visualize the optimal approach to end your simulation successfully.

© 2013-2022 TakeTheWind - CONFIDENTIAL 4 4 August 2022

 Differential diagnosis
Multiple choice question presented to the trainee in order to confirm whether they got the diagnosis right.

Summative question:

Question What is the most likely diagnosis?

Correct answer Blunt trauma

3 Incorrect answers Cardiogenic shock

Cardiac tamponade

Left hypertensive pneumothorax

© 2013-2022 TakeTheWind - CONFIDENTIAL 5 4 August 2022

QUICK
SOLUTION
GUIDE
SEVERE POLYTRAUMA DUE TO A
PEDESTRIAN VERSUS MOTOR VEHICLE
ACCIDENT

SCENARIO #362
NAME
KENNETH JONES

SPECIALTY
Trauma

SCENARIO DIFFICULTY
ADVANCED

SIMULATION ENVIRONMENT
INTRA HOSPITAL - EMERGENCY ROOM

This patient is not a real patient and the clinical case, while clinically plausible, is fictional.
 Physical examination
Perform the following physical examinations:

Airway
- Airway observation
Breathing
- O2 Sat (%)
- Pulmonary auscultation
- Respiratory rate (/min)
Circulation
- Abdominal evaluation
- Blood pressure (mmHg)
- Capillary refill time (s)
- Heart rate (bpm)
- Limb assessment
- Pelvic assessment

Medical tests
Request the following medical tests:

Imaging
- Chest X-ray
- FAST
- Head CT
- Lower limbs X-ray
Lab tests
- Arterial blood gas
- Blood typing

Treatments
Administer the following treatments:

Tranexamic acid

© 2013-2023 TakeTheWind - CONFIDENTIAL 1 10 October 2023

 - Medications > Procoagulants > Tranexamic acid
Ventilation
- Interventions > Ventilation - Mechanical > Invasive ventilation (orotracheal tube)
Chest drain
- Interventions > Punctures & drainage > Left chest drain
Transfusion
- Interventions > Transfusions > Erythrocytes transfusion
Neurosurgeon
- Call > Neurosurgery
Operating room. One of the following:
- Call > Send to OR
- Call > Operating room
IV peripheral catheter (R/L)
- Interventions > Catheters & tubes > IV peripheral catheter (R/L)

© 2013-2023 TakeTheWind - CONFIDENTIAL 2 10 October 2023

 Baseline
Visualize the baseline approach. The baseline predicts scenario behavior assuming no actions by the trainee, which usually
represents the worst-case scenario.

© 2013-2023 TakeTheWind - CONFIDENTIAL 3 10 October 2023

 Optimal approach
Visualize the optimal approach to end your simulation successfully.

© 2013-2023 TakeTheWind - CONFIDENTIAL 4 10 October 2023

 Assessment question(s) during the simulation (session
only)
Questions presented to the trainee in order to have a more detailed evaluation of the use of the clinical scenario.

Assessment question(s)
Questions presented to the trainee in order to have a more detailed evaluation of the use of the clinical scenario.

Summative Multiple Choice

Question question:

Question What is the most likely

diagnosis?

Correct answer In severe polytrauma

resuscitation is the priority, not
diagnosis

3 Incorrect answer(s) Acute subdural hematoma

Moderate left hemothorax

Hemorrhagic shock

© 2013-2023 TakeTheWind - CONFIDENTIAL 5 10 October 2023