Professional Documents
Culture Documents
Section 1: Demographics
Case Title: Respiratory Distress in the Pediatric Patient
Case Description & Diagnosis: The nurse enters the patient room to find the child in
mild respiratory distress. He then progresses to severe respiratory distress. The nurse
must then follow the PEARS algorithm to treat the patient. The patient has an upper
airway obstruction (blockage of the large airway - upper trachea) from the endotracheal
tube.
Learning Objectives:
● Recognize a seriously ill or injured child using a systematic approach
● Begin to stabilize a child in respiratory distress
● Practice effective team interaction
● Define the "initial impression"
● Explain how to utilize a systematic approach algorithm
● Discuss the evaluate, identify, intervene sequence
● List 5 elements in evaluation of breathing
● Identify signs and symptoms of and interventions for upper airway obstruction,
● Recognize signs of and describe interventions for mild and severe respiratory
distress
● Recognize signs of inadequate oxygenation and inadequate ventilation
References used:
● American Heart Association PEARS Provider Manual
Section 3: Preparation
1. Simulator
a. “Timmy” manikin
2. Machines
a. Pediatric crash cart
b. Patient monitor
c. Pediatric nebulizer
3. Supplies
a. Pulse-ox monitor
b. Stethoscope
c. IV with NaCl (running at 125 cc/hour)
d. Empty Azithromycin secondary bag
e. IV pump
f. Epinephrine for nebulizer
g. Pediatric non-rebreather O2 mask
h. Pediatric nasal cannula
i. Pediatric ambu-bag
j. Steri-strips on right lower abdomen (appendectomy)
4. Supporting Materials:
a. Labs
i. Hgb 4.0
ii. Hct 37
iii. WBC 21.1
b. Handouts
i. Patient chart
ii. PEARS algorithm
Standardized Actors/Roles:
1. Timmy- 7 year old male
2. Mother- 35 year old female who is anxious about her son’s condition but is
understanding and trusts the medical team and their decisions
Time Duration
Set-up 30 minutes
Preparation for
15 minutes
students
Simulation 30 minutes
Debrief 30 minutes
Section 4: Simulation Exercise
How the Scenario unfolds: The students must perform an assessment and as the
assessment is taking place Timmy’s respirations increase, he has nasal flaring and
retractions. He starts to drool and his lung sounds show decreased air movement. If the
students do not take action, he starts to have a slow respiratory rate, grunting,
bradycardia, mottling and cyanosis, and a decreased level of consciousness
Critical Action Items: Early detection of respiratory distress, give O2, determine the
cause of respiratory distress
Actual course of events and outcomes (for real patient cases): Timmy’s airway is
narrowed due to tissue injury from the endotracheal tube.
Reactions
Understanding (advocacy/inquiry)
6. Now that you have completed this simulation, how will this (if any)
Summary