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COVID-19 Pneumonia and Status Asthmaticus With Respiratory Failure in a Pediatric Patient: A Simulation for Emergency
Hoi See Tsao1, Mariann Nocera Kelley2, Lauren Allister3
1Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center.
Insights
Medical simulation effectively trained residents to manage pediatric respiratory failure from COVID-19. This approach enhanced provider confidence and preparedness for critical care scenarios involving novel infectious diseases.
Area of Science:
- Medical Education
- Pediatric Emergency Medicine
- Infectious Diseases
Background:
- During COVID-19 surges, medical trainees faced novel patient care challenges, including pediatric respiratory failure.
- Effective management of critically ill children with COVID-19 requires specialized skills and team protection.
- Simulation offers a safe, controlled environment for practicing these critical skills.
Observation:
- A simulation involved pediatric emergency medicine fellows and residents managing a 13-year-old male with obesity, COVID-19 pneumonia, status asthmaticus, and respiratory failure.
- Learners practiced identifying symptoms, evaluating, and managing the complex pediatric case while adhering to COVID-19 exposure protocols.
- Twenty-eight trainees participated, completing a post-simulation survey on their experience and confidence.
Findings:
- The simulation was highly effective, with most learners rating it 5.0 for teaching the evaluation and management of COVID-19-related respiratory failure.
- Participants found the case highly relevant to their clinical practice.
- Learners reported increased confidence in managing pediatric patients with COVID-19 pneumonia, status asthmaticus, and respiratory failure.
Implications:
- Simulation-based training is crucial for preparing healthcare providers for emergent pediatric conditions during pandemics.
- Future iterations can incorporate updated COVID-19 knowledge, advanced personal protective equipment (PPE) practices, and telesimulation.
- Adapting this simulation model can enhance preparedness across various healthcare provider roles.
Introduction:
During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care for these children while protecting the health care team. Simulation is an important tool for giving learners a safe environment in which to learn and practice these new skills.
Methods:
In this simulation, learners provided care to a 13-year-old male with obesity, COVID-19 pneumonia, status asthmaticus, and respiratory failure. Target learners were pediatric emergency medicine fellows and emergency medicine residents. Providers were expected to identify the signs and symptoms of status asthmaticus, pneumonia, and respiratory failure and demonstrate appropriate evaluation and management while minimizing COVID-19 exposure. Participants completed a postsimulation survey on their satisfaction and confidence in performing the objectives.
Results:
Twenty-eight PGY 1-PGY 6 learners participated in this simulation. The postsimulation survey showed that most learners felt the simulation was effective in teaching the evaluation and management of respiratory failure due to COVID-19 (M = 5.0; 95% CI, 4.9-5.0) and was relevant to their work (M = 5.0; 95% CI, 5.0-5.0).
Discussion:
Learners felt that the case was effective in teaching the skills needed to care for a child with COVID-19 pneumonia, status asthmaticus, and respiratory failure. Future directions include updating the case with new COVID-19 knowledge and personal protective equipment practices gained over time, using hybrid telesimulation to increase learners' exposure to the case, and adapting the case for other health care providers.
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