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Coronavirus-19 Multisystem Inflammatory Syndrome in Children (MIS-C): A Pediatric Simulation Case for Residents,
Dhritiman Gurkha1, Katie Cashen2, Paul Patek1
1Fellow, Department of Pediatric Emergency Medicine, Oakland University William Beaumont School of Medicine.
Insights
Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19. A high-fidelity simulation effectively trained healthcare providers to recognize and manage MIS-C, improving their confidence and knowledge.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Medical Simulation
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe hyperinflammatory condition associated with SARS-CoV-2.
- Early recognition and management are critical for pediatric patients presenting with MIS-C, often requiring intensive care and resuscitation.
Purpose of the Study:
- To evaluate the effectiveness of a high-fidelity simulation case in training healthcare providers to recognize and manage MIS-C.
- To enhance provider confidence and competence in managing MIS-C and its associated sequelae.
Main Methods:
- A real-patient-based, high-fidelity simulation scenario was developed for pediatric emergency medicine fellows, residents, and advanced practice providers.
- The simulation involved recognizing MIS-C and managing shock and arrhythmia using resuscitation principles.
- A 25-minute simulation was followed by a 15-20 minute debriefing and written evaluation.
Main Results:
- Twenty-five healthcare providers participated in the simulation over three months.
- All 20 participants who completed the evaluation reported increased confidence, comfort, and knowledge in managing MIS-C.
- Participants rated their increased knowledge and comfort with an average score of 5 out of 5.
Conclusions:
- High-fidelity simulation provides an effective platform for healthcare providers to gain confidence and proficiency in managing MIS-C.
- This training approach can improve the readiness of pediatric care teams to address this critical condition.
Introduction:
A rare but serious condition often requiring intensive care, multisystem inflammatory syndrome in children (MIS-C) is characterized by hyperinflammatory shock related to the SARS-CoV-2 pandemic. This resource teaches residents, pediatric emergency medicine fellows, and advanced practice providers who care for children to recognize and manage MIS-C and associated sequelae while applying the basic principles of pediatric resuscitation.
Methods:
The simulation case was based on a real patient who presented to the emergency department with fever, rash, and cardiogenic shock. We designed the scenario to be used with a high-fidelity school-age mannequin in an emergency center resuscitation room or simulation lab. The case took 25 minutes to run, followed by a 15- to 20-minute debrief session. Personnel required for the case included a simulation technician, case instructor, emergency department nurse, parent, and consultant. Learners had to recognize the syndrome and treat the resultant shock and arrhythmia with a combination of vasopressors, antiarrhythmics, and defibrillation. Afterward, learners participated in a formal debriefing session and completed a written evaluation.
Results:
Twenty-five learners (six pediatric emergency medicine fellows, 12 residents, and seven advanced practice providers) participated in the scenario over a 3-month period. The written evaluation was completed by 20 of the 25 participants; all 20 felt their confidence, comfort, and knowledge regarding the topic had increased, with an average score of 5 (strongly agree) on a 5-point Likert scale.
Discussion:
This simulation case offers an effective experience for learners to become comfortable and confident in recognizing and managing MIS-C.
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