1. Instructor: Human Patient Simulator Scenarios
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Basic Disaster Life Support

2. Objectives Teaching points & critical actions
Basic simulator orientation and function
Accomplishing the station objectives:
Practice clinical scenarios likely encountered in all-hazards topics utilizing human patient simulators
Practice essential clinical skills that maybe necessary in the patient management of all-hazards training scenarios
Objectives:
If you complete all the skills stations, these are the 4 objectives you will have the opportunity to meet.
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3. Plan Slideset Example Introduction by Faculty
Introduction to Simulation
Student Assess “Normal” Exam
Assign Groups
Rotate Through Clinical Simulations
Slideset Example
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4. General Comments Timing of skill stations Varies by clinical scenario
Varies by student provider level
Number of students and faculty
Balance of simulation vs. time course
Instructor selection is important
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5. The Scenarios Total / Max. of 4 scenarios
Scenarios are designed to reinforce the “All Hazards” philosophy of ADLS
2 basic and 2 advanced scenarios
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6. General Comments Order of scenarios Be ready to improvise and assist
Simple (regarding simulator assessment) should likely be first
Be ready to improvise and assist
Guide the group
Keep all engaged
Ask questions
Teach through obvious knowledge gaps
Role playing “changing hats”
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7. Important Warnings Very important to inform the students
Clearly need to state:
Purpose for the safety, skills knowledge vs. privileges, etc…
If not clearly stated, some WILL assume their own conclusions.
What you do not say is communicated LOUDLY!
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8. ADLS Skills Stations Slideset Example Student’s are aware and agree:
SAFETY FIRST!
If you hear the command “STOP PLAY”
Stop training
Follow instructors directions
It is important for the students to be safety mined always. The use of the command “STOP PLAY” by an instructor must be complied with. Upon hearing this command the students are to stop the exercise immediately in a safe manner and follow the instructors instructions.
In addition to the other warning and cautions given, here the last bullet reinforces the student to self assess their ability and current status regarding participating in PPE training and use. Anyone with a chronic or active respiratory symptoms, condition or illness should not participate. As the use of the PPE could worsen these conditions. Any one who experiences and difficulty breathing or feels ill in any way should not participate.
It is important to stress to all the students that if they become ill or develop any concerning symptoms such as difficulty breathing, chest pain, feel weak or faint , etc.. They are to immediately stop participating and notify their instructor at immediately.
Slideset Example
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9. ADLS Skills Stations Slideset Example Student’s are aware and agree:
Many different levels of responders and healthcare providers
Various different skill sets, licenses, certifications, and regions represented
Regarding clinical skills or procedures demonstrated or performed:
ADLS is not certifying or authorizing you to do any.
They are included to complement the realistic training scenarios
It is important for all students to understand:
Because there are many different levels of responders and providers in any given ADLS course, all instructors and students need to keep in mind that they represent a variety of differenct skill sets, etc… If a given student is not previously trained in a given procedure or unfamiliar with it, they should not attempt to perform it during training.
Essential clinical skills and procedures that are useful during all-hazards scenarios are available to be practiced. The purpose of practicing these skills is for the participants to understand when and how such clinical skills and procedures might be integrated into overall patient management. For example, for those providers proficient in endotracheal intubation, the ADLS Skill Stations allows them to practice this procedure while in PPE. This allows the practitioner to understand the impact that all-hazards preparedness may have on routine clinical skills and procedures. Please note that the ADLS course or its sponsoring organizations does NOT certify or authorize any participant to perform any clinical skill or procedure.
Slideset Example
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10. ADLS Skills Stations Slideset Example Student’s are aware and agree:
Inherent risks involved in utilizing equipment and skill demonstration training
Safe personal clinical health status to participate in the activities
The responsibility for determination of individual student limitations or abilities to participate is the sole responsibility of the individual student
Can elect to not participate
in any activity
Students are made aware:
By registering for the ADLS course the participant recognizes that there are inherent risks involved in using equipment and skill demonstration training, and that their personal clinical health status allows them to participate in the activities. Any question regarding this issue must be addressed before participation in the ADLS Skill Stations. Our intention is to provide a safe and productive learning environment for participants. However, the responsibility for determining individual participant limitations or abilities to participate is the sole responsibility of the individual participant. A participant may elect to abstain from taking part in any given activity.
Slideset Example
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11. Clinical Skill Safety Slideset Example
If you perform, must keep the environment safe for all students and faculty
Sharps, Spills, and Shocks
May simulate all clinical actions through discussion if team or individual is unable or uncomfortable to perform
Slideset Example
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12. HPS Station Format Introduction of faculty and students
Present the simulators
Demonstrate how to interact with the simulator
What is normal for the simulator
Divide students into groups
Start the first scenario
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13. Scenario Components Setup Background Simulator details Scenario flow
Critical actions
Teaching points
Evaluation
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14. Reinforce Key Learning Points
Review the DISASTER paradigm
“I.D. me”
Review the R.E.D. Survey
Casualty survey
Incident surveys
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15. D-I-S-A-S-T-E-R Paradigm
D – Detect
I – Incident Command
S – Scene Security and Safety
A – Assess Hazards
S – Support
T - Triage and Treatment
E – Evacuation
R – Recovery
DISASTER Paradigm:
Review as needed.
Slideset Example
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16. Before Patient Care Initiated!
Incident Survey
Incident “ABCDE” exam
A = Aware of All-hazards
B = Barrier
C = Contain
D = D.I.S.A.S.T.E.R.
E = Enter (Exit)
Before Patient Care Initiated!
Incident Survey:
Review as needed.
Slideset Example
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17. Casualty Survey Slideset Example A: Airway B: Breathing C: Circulation
D: Differential Dx, Detection & Delivery
E: Evaluate or Evacuate (Exit)
Casualty Survey:
Review as needed.
Slideset Example
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18. Power Point Simulator Introduction
Experience level of students
Your experience level
Technical support
Reinforce the “big picture”
Today, brief encounters
Future, encourage to utilize similar training
“value of normal” discussion
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19. Human Patient Simulator Scenarios
Patient Assessment
History
Ask the “patient”
Physical Exam
Examine the “patient”
Are there heart sounds?
Lung sounds?
Are there pulses?
Suspend reality…
The benefits of “realistic” simulation:
Many participants have commented that these are the most realistic training experiences they have ever encountered. In many ways, the simulators allow the student to suspend reality and actually treat the “patient.” They can ask the patient questions. If the participant is wondering whether the fractured-looking lower extremity has a pulse, they do not ask an instructor. Instead, they feel for pulses in the usual anatomic locations and determine the answer themselves. Examining the “patient” and not waiting for instructor prompts, completes reassessment following interventions.
Slideset Example
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20. Human Patient Simulator Scenarios
Patient Treatment:
Airway
Breathing
Circulation
Medications
Life saving procedures
Examine responses
Patient Treatment:
The opportunity to actually identify and treat the human simulators in a very “real” manner is effective in training.
The ability to identify and treat common airway, breathing and circulation clinical emergencies utilizing common modalities and methods is present.
For example:
Needle decompression of the pneumothorax on the human simulator can be performed using typical clinical practice equipment, and when it is performed correctly the chest wall will returns to normal motion. The responder can auscultate the return of breath sounds and the note the appropriate changes in vital signs in the simulated patient as would occur with an actual patient.
After a given intervention is performed, the student can then monitor the human simulator in for the physiologic responses to detect improvement or other clinical responses.
Slideset Example
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21. Immediate Life Saving Skills, for example...
Instructors must be skillful in the likely utilized procedures / interventions
More important…. Instructors must be skillful in the UN-likely utilized procedures / interventions
Immediate Life Saving Skills:
The application of the immediate life-saving skills in step 3 of the RED survey must be made in keeping with the triage process, available resources, and the skill set of the responder. Initially, noninvasive methods should be used such as manually opening a victim’s airway or direct pressure for uncontrolled bleeding. Essential advanced life-saving skills such as endotracheal intubation, needle cricothyroidotomy, needle decompression of a pneumothorax, and pericardiocentesis may be indicated. Whether or not an antidote can be administered is dependent upon the responder’s skill level and the availability of the appropriate pharmaceuticals.
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22. Immediate Life Saving Skills, for example...
Airway:
Manual, ET Intubation, Needle Cricothyroidotomy
Breathing:
Needle Decompression
Circulation:
Uncontrolled bleeding management,
Pericardiocentesis
Detection of agents and antidote delivery
Immediate Life Saving Skills:
The application of the immediate life-saving skills in step 3 of the RED survey must be made in keeping with the triage process, available resources, and the skill set of the responder. Initially, noninvasive methods should be used such as manually opening a victim’s airway or direct pressure for uncontrolled bleeding. Essential advanced life-saving skills such as endotracheal intubation, needle cricothyroidotomy, needle decompression of a pneumothorax, and pericardiocentesis may be indicated. Whether or not an antidote can be administered is dependent upon the responder’s skill level and the availability of the appropriate pharmaceuticals.
Slideset Example
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23. General Comments
Handling atypical or wrong choices in clinical management
Goal is to facilitate learning
Monitor time spent on wrong pathways
Scenario set up
Testing equipment
Scenario props and scene preparation
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24. What to do when? Simulator does not respond right
Students are completely off track
The simulator is circling the drain
Do you let it go
Do you stop the scenario
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25. Let’s Learn… Scenarios Discussion
Simulator Demonstration and Discussion
Hand’s on…
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26. Thank you!
Questions?
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