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Severe Myocarditis in the Pediatric Patient: A Simulation for Emergency Department Management
Prayerna Uppal1,2, Anita Thomas3, Robyn Wing4
1Department of Pediatrics, Seattle Children's Hospital, Seattle, USA.
Insights
Pediatric myocarditis, often presenting with vague symptoms, requires prompt diagnosis and intervention to prevent severe outcomes like cardiogenic shock. This simulation highlights the critical need for rapid identification and treatment in emergency departments.
Area of Science:
- Pediatric Cardiology
- Emergency Medicine
- Medical Simulation
Background:
- Myocarditis in children presents with diverse signs, complicating diagnosis and potentially delaying critical interventions.
- Delayed diagnosis and treatment of pediatric myocarditis can lead to adverse outcomes, including cardiogenic shock and arrhythmias.
Purpose of the Study:
- To familiarize emergency department (ED) providers with the nonspecific presentation of pediatric myocarditis.
- To educate care teams on interventions impacting patient stabilization in myocarditis cases.
- To reinforce the severe consequences of delayed interventions for pediatric myocarditis.
Main Methods:
- Utilized a simulated five-year-old patient case of myocarditis with secondary cardiogenic shock.
- Designed a simulation curriculum for ED trainees and providers.
Main Results:
- The simulation aimed to improve recognition of nonspecific pediatric myocarditis symptoms.
- It emphasized the impact of timely versus delayed interventions on patient outcomes.
- Reinforced the link between delayed care and progression to cardiogenic shock or fatal arrhythmias.
Conclusions:
- Simulation is a valuable tool for training ED providers on managing pediatric myocarditis.
- Prompt identification and intervention are crucial for improving outcomes in pediatric myocarditis and preventing cardiogenic shock.
Abstract:
Myocarditis in a pediatric patient can present with a variety of signs and symptoms, leading to a broad differential diagnosis. Delays in the correct identification of myocarditis and the initiation of appropriate interventions can have a detrimental impact on patient outcomes. In this case, a simulated five-year-old patient with myocarditis and secondary cardiogenic shock presents to the emergency department (ED). The goals of this simulation curriculum were to familiarize trainees and ED providers with the often nonspecific presentation of pediatric myocarditis, educate the care team about crucial interventions that positively or negatively impact the patient's stabilization course, and reinforce the consequences of delays in appropriate interventions, such as progression of cardiogenic shock and potentially fatal arrhythmias.
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