A Pediatric Death from Non-Accidental Trauma

• Published in: MedEdPORTAL Vol. 11
• Main Authors: Beattie, Lars, Ryan, Matthew, Rowe, Joel, Mazin, Ryan
• Format: Journal Article
• Language: English
• Published: Association of American Medical Colleges 01.04.2015
• Subjects: Cardiopulmonary Resuscitation; Child Abuse; CPR; Ethics; Hemothorax; Pelvic Fracture
• ISSN: 2374-8265; 2374-8265
• DOI: 10.15766/mep_2374-8265.10064

Abstract This resource is a simulation for learners of emergency medicine (nurses, medical students, residents, and faculty) designed to provide the experience of a rare, but important, emergency department scenario: a pediatric death. Being an extremely uncommon scenario, the main goal of this case is to provide a forum where learners can practice the skills needed to navigate through such an emotionally charged event. There is flexibility in the case to allow for varying training levels of participants. We have run this simulation four times in our emergency medicine conference group simulation sessions. The case takes about 15-20 minutes to run, followed by a debrief lasting anywhere from 30-40 minutes. The teams have consisted of three residents and a medical student. An additional 25-30 medical students, residents, and faculty were present to observe as the case has been run in our residency conferences. The debriefing session is run by the designated faculty observer. The case requires some time to prepare. At minimum it requires three confederates, a technician, someone to project the stimuli, and a faculty observer. Still, given the paucity of real pediatric death experiences that the residents are expected to be part of, we believe this an important enough simulation to invest the resources required. Overall, we feel that it creates an effective environment to expose learners to a pediatric code and death in the emergency department. It helps the participants develop skills to manage the psychosocial aspects of a pediatric death, and practice medical interventions used in a pediatric resuscitation. It also provides opportunities for learners to understand the options to engage parents during a resuscitation of their child, and to recognize when resuscitation attempts are futile.