Simulation Notes: Room-by-Room Cases and Key Procedures
Room 208: Caleb Vasquez
Caleb is an -year-old patient with a ventriculoperitoneal (VP) shunt revision. If you have not covered neuro topics yet, you should look up what VP stands for and why a shunt is used, as well as common reasons for a shunt revision (e.g., malfunction, obstruction, infection, or over-drainage). In this room you will perform vital signs, noting that there is no blood pressure measurement available, so you will obtain only heart rate and respirations to assess age-appropriate norms. Caleb has a head dressing, so you need to palpate and assess around the shunt site and dressing to check for signs of leakage, swelling, or infection. The case indicates that he is going home either today or tomorrow, so you must provide discharge instructions to the family and ensure they understand post-discharge care. Communication should be developmentally appropriate: you should talk with the patient and with the family, recognizing that in acute care settings an adult guardian must be present with the patient at all times if the patient is under the facility’s age threshold. The policy mentioned in the session states that guardian or parent must accompany the patient at all times for most facilities, and it specifically notes that for patients who are 14 years old, a guardian must be present. The instructor shared an anecdote about balancing care for multiple patients (often four to five on the floor) and the importance of not leaving a patient unattended with unlicensed personnel, due to the workload and consented responsibilities of staff. Even if the patient is a newborn or nonverbal, the clinician should still talk to the patient; communication should also include informing the parents about what to expect and how to communicate with their child. The session also mentions a scanning system (the Sim de Gro) for administering medications to two patients; you will take turns using one scanner. This room emphasizes careful patient communication, neuro assessment, and post-discharge education in addition to vital signs and wound/dressing assessment.
Room 209: Luis Dominguez
Luis Dominguez is a -year-old with a fractured arm. The case provides cues that could raise suspicion for child abuse, so you must remain alert for safeguarding concerns and document appropriately. His arm is wrapped with an ACE bandage, and you must not remove or undo this wrap because it is there to stabilize the fracture while awaiting surgery. There will be accompanying parents; you should practice and demonstrate effective communication with both the child and the parents, particularly since the father is described as likely to become upset or loud. This section highlights the importance of recognizing and addressing potential abuse cues, staying calm, and communicating clearly with the family while ensuring the child’s safety and proper care until surgical intervention.
Room 212: Annie Greer
Annie Greer is a -year-old awaiting surgery for appendicitis. She requires a restart of her IV because the line was pulled out when she went to the restroom. The simulation provides only one IV catheter, but you may use your own if you have one. If you do not obtain IV access on the vein, you will only get one attempt. The instructor emphasizes bringing your own IV catheters for SIM to avoid limitations in the scenario. After initiating the IV, you will receive feedback; when the case is complete, you will remove the IV, clean the arm, and return all supplies. Flushes are to be recycled; do not throw away caps or syringes, as there is a designated site for refilling supplies. In addition to IV management, you will provide preoperative teaching to Annie and her family so they understand the upcoming procedure and what to expect. This room underscores practical skills (IV placement and maintenance), resourcefulness (bringing own supplies), and preoperative education.
Room 214: Jonathan Garcia and Michael Castro
In this room there are two patients: Jonathan Garcia, a -year-old with a new diagnosis of type 1 diabetes, and Michael Castro, a -year-old with an exacerbation of asthma. For Jonathan, you must obtain vital signs and interpret the provided blood glucose value; you will perform interventions based on the blood sugar and provide education to both the child and the family. Jonathan has an injection pad, and medications for him should be administered directly to the patient rather than onto a table.
Michael presents with asthma and requires vital signs, assessment, and appropriate interventions based on your findings. He has a saline lock in his right arm, which means you will administer medications and flush through that saline lock as needed. You will also administer an inhalation therapy (described as a treatment with compressed air in this simulation). This indicates that you will perform inhalation therapy as part of asthma management and teach the family about the process. For Michael, you will handle medication administration through the saline lock, perform flushing, and document the interventions thoroughly. It is noted that Michael will require the most documentation among the two patients in this room, so plan for a longer within-room workflow for him. Overall, each patient in every room should be managed within about minutes to maintain throughput.
Additionally, the session emphasizes the overall workflow: the Sim de Gro scanning system will be used to administer medications to two patients on one scanner, with staff taking turns. The emphasis on documentation, patient education, and timely care is a recurring theme. The session also notes that case-reading should include direct communication with patients and their families, ensuring that adults are present where required, and tailoring conversations to the patient’s developmental stage. Finally, the speaker invites you to walk through the room with them, reinforcing a hands-on approach to learning and patient interaction in the simulated environment.