Fever and Seizure in a Young Infant: A Simulation Case

Area of Science:

• Pediatric Emergency Medicine
• Medical Simulation
• Neonatal Care

Background:

• Fever in infants presents diagnostic and management challenges, including recognizing critical illnesses like meningitis.
• Residents often lack proficiency in essential bedside procedures due to limited medical school opportunities.
• This simulation focuses on fever, seizures, and potential bacterial meningitis in infants.

Purpose of the Study:

• To provide a 2-hour simulation case for subinterns and other trainees (pediatrics, family medicine, emergency medicine).
• To improve residents' competence in recognizing and managing critical illness in febrile infants.
• To enhance skills in performing essential bedside procedures.

Main Methods:

• A 5-week-old infant mannequin presents with fever, lethargy, and seizures requiring respiratory support.
• Key procedures include obtaining IV access, blood/urine cultures, lumbar puncture, and bag-mask ventilation.
• The simulation culminates in a diagnosis of bacterial meningitis.

Main Results:

• A pilot study showed significant improvement in perceived competence in diagnosis, management, and procedural skills among pediatric subinterns.
• Critical actions practiced include IV access, cultures, lumbar puncture, respiratory support, and medication administration.
• Students demonstrated enhanced ability in managing complex pediatric cases.

Conclusions:

• The clinical simulation effectively develops clinical reasoning, procedural skills (lumbar puncture, bag-mask ventilation), and management abilities.
• It allows for self-assessment of competency in procedural, diagnostic, and management skills.
• This case is a valuable tool for training healthcare professionals in managing febrile infants with serious conditions.