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This summary is machine-generated.

This simulation effectively trains emergency medicine providers in managing lower GI bleeding and reversing anticoagulation in patients with abnormal coagulation. The realistic case is a valuable tool for improving patient care and outcomes.

Keywords:
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Area of Science:

  • Medical Education
  • Emergency Medicine
  • Gastroenterology

Background:

  • Gastrointestinal (GI) bleeding, particularly lower GI bleeding, is an increasing concern, especially in aging populations and those on anticoagulation.
  • Abnormal coagulation significantly elevates the risk of life-threatening GI bleeding, necessitating rapid diagnosis and management.
  • Simulation offers a practical approach to train healthcare providers in recognizing and managing complex conditions like lower GI bleeding.

Purpose of the Study:

  • To develop and evaluate a high-fidelity simulation case for training emergency medicine residents in managing lower GI bleeding.
  • To assess the simulation's effectiveness in teaching the recognition of hemorrhagic shock and the reversal of anticoagulation.
  • To provide a realistic training scenario for managing patients with lower GI bleeding secondary to intentional rodenticide ingestion.

Main Methods:

  • A high-fidelity simulator was used to create a case of a 58-year-old female with lower GI bleeding and abnormal coagulation due to rodenticide ingestion.
  • Emergency medicine residents were tasked with identifying the GI bleed, recognizing hemorrhagic shock, reversing anticoagulation, and initiating resuscitation.
  • Learners completed a post-simulation survey to evaluate the realism and utility of the case and debriefing.

Main Results:

  • The simulation case was conducted at the University of Pennsylvania Simulation Center with 28 emergency medicine residents.
  • A significant majority of learners (71%) found the simulation realistic, and 86% agreed or strongly agreed on its usefulness.
  • The case successfully facilitated practice in managing lower GI bleeding and anticoagulation reversal.

Conclusions:

  • This simulation case provides a straightforward, resource-efficient method for training in lower GI bleeding management.
  • The simulation is well-received by learners and effectively reinforces critical management skills for abnormal coagulation scenarios.
  • Implementing such simulations can enhance provider preparedness for life-threatening GI bleeding events.