Diabetic Ketoacidosis in the Obstetric Population: A Simulation Scenario for Anesthesia Providers

Clark Obr; Anthony Mueller

doi:10.15766/mep_2374-8265.10406

Introduction: This simulation on diabetic ketoacidosis (DKA) in the obstetric population presents learners with one of the more commonly encountered etiologies of critical illness in the pregnant patient. It was developed for anesthesiology resident physicians with some background knowledge and experience caring for critically ill patients. Firsthand experience with obstetric anesthesia is not necessary, but background knowledge of the physiologic changes of pregnancy is helpful. Methods: This simulation is designed to be delivered in a single 1-hour session. Educational objectives are designed to reinforce the educational milestones for anesthesiology set forth by the Accreditation Council for Graduate Medical Education and the American Board of Anesthesiology. Materials contained within this simulation include a case template designed to provide facilitators with a general overview of the simulation and a checklist of critical actions that each learner should perform during the scenario. Also included are a brief summary designed to reinforce knowledge gained through this simulation and an evaluation form used to assess the learner's view of the educational value of this activity. Results: Several eligible learners from the University of Iowa Department of Anesthesiology experienced this simulation content. Comments were generally positive, including “high quality learning and information given” and “It was a good [simulation] focusing on things we don't necessarily talk about.” All learners who returned surveys regarding the simulation answered the question “This simulation enhanced my understanding of how to manage critically ill patients in the perioperative period” with either agree or strongly agree (4 or 5 out of 5). Discussion: This module could be used to improve training on diagnosis and treatment of DKA independent of the focus on obstetrics; by modifying the scenario slightly (emergency general surgery or no surgical issue instead of term pregnancy, for example), the simulation can be tailored to a broader, more diverse target group of learners. ------------------------------ Educational Objectives By the end of this simulation, the learner will be able to: 1. Discuss the diagnosis and management of diabetic ketoacidosis in the obstetric population. 2. Discuss rationale for delaying nonemergent surgery in a patient not medically optimized for surgery. 3. Discuss preparation for emergent surgery in the critically ill obstetric patient. 4. Discuss and demonstrate management of a neonate with a poor response to initial resuscitation. 5. Discuss areas of strength and areas for improvement discovered during the simulation. --------------------------------- Includes simulation case, supplemental data, critical actions checklist, debriefing summary and evaluation form.

Diabetic Ketoacidosis in the Obstetric Population: A Simulation Scenario for Anesthesia Providers

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