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Screen based learning

 

All the following software is available for free to any student, resident, nurse, physician or other person with a University of Washington UW NetID. You can install and use the software on any Windows computer. Requires Microsoft .Net 2.0 and Internet Explorer 6.0 or higher. The software is provided courtesy of the Anesthesia Department of the University of Washington and Anesoft©

Before launching the modules, please make note of the case number you wish to use in the simulator.


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Topic Case Title Description Module Module URL
Ventricular fibrillationCase 1 - V Fib arrestUnwitnessed V Fib arrest. Assess the patient, call for help, CPR, defib, CPR, defib. Resume CPR for 5 cycles even with return of rhythm.ACLSOpen ACLS Module
Bradycardia - heart blocksCase 10 - Chest pain with slow rateThis case will provide the opportunity to review the bradycardia algorithm.ACLSOpen ACLS Module
Tachycardia - Unstable ventricular tachycardiaCase 11 - Rapid heart rate in recovery roomThe patient has monomorphic ventricular tachycardia with a pulse but has chest pain so should be considered unstable. Use electrical cardioversion immediately.ACLSOpen ACLS Module
Tachycardia - Stable ventricular tachycardiaCase 12 - Rapid rate in Cardiac Care UnitTry loading this stable patient with amiodarone prior to electrical cardioversion.ACLSOpen ACLS Module
Torsades de PointesCase 13 - Confusion in the emergency roomCall for an expert. Torsades is associated with long QT interval. Avoid agents that can prolong the QT such as quinidine or procainamide. Try magnesium infusion.ACLSOpen ACLS Module
Tachycardia - Paroxysmal supraventricular tachycardiaCase 14 - Fluttering in her chestSince this patient is stable you can try medications such as diltizem or esmolol.ACLSOpen ACLS Module
Tachycardia - Atrial FibrillationCase 15 - Palpitations in the emergency roomSince this patient is stable and ventricular function is not impaired, you can try to slow the ventricular response with diltiazem or esmolol.ACLSOpen ACLS Module
Tachycardia - Wide complex of unknown originCase 16 - Positive exercise stress testSince this patient is stable, you can try amiodarone before electrical cardioversion.ACLSOpen ACLS Module
Ventricular fibrillationCase 2 - Witnessed arrest!In the unusual situation of a witnessed arrest with a defibrillator immediately availble, you should defibrillate without delay for CPR.ACLSOpen ACLS Module
Ventricular fibrillationCase 3 - Sudden collapse at health clubYou should intubate after the first two electrical defibrillation attempts. The administration of vasopressors, epinephrine or vasopressin, may be helpful. Then shock again.ACLSOpen ACLS Module
Ventricular fibrillationCase 4 - Arrest in the delivery roomThe pulseless person is the anxious husband, not the laboring mother. This case reviews the management when IV access is difficult to establish.ACLSOpen ACLS Module
Ventricular fibrillationCase 5 - Woman found pulseless at homeAmiodarone is the next drug to try after epinephrine or vasopressin. Continue aggressive chest compressions and repeat electrical defibrillation attempts.ACLSOpen ACLS Module
Ventricular tachycardia - PulselessCase 6 - Arrest on the medicine wardIn an unwitnessed arrest, immediately perform 5 cycles of 30 breaths : 2 compressions CPR. Then use unsynchronised cardioversion. Repeat CPR and repeat cardioversion.ACLSOpen ACLS Module
Pulseless ventricular tachycardiaCase 7 - Arrest on the post-op surgery wardAs in ventricular fibrillation, after the first two shocks, intubate, administer epinephrine/vasopressin,shock, amiodarone, shock.ACLSOpen ACLS Module
Pulseless electrical activityCase 8 - Pulseless trauma victimPerform aggressive CPR, intubate, administer fluids and epinephrine while searching for a treatable cause of PEA.ACLSOpen ACLS Module
AsystoleCase 9 - Code Blue in cardiac rehabAggressive CPR, ventilation with bag and mask, epinephrine, while searching for a treatable cause. You will need to consider when to cease resuscitation efforts in this case.ACLSOpen ACLS Module
Routine inductionCase 1 - 47 year old for diagnostic laparoscopyThis is an introductory case. The Help-Instructions will walk you step by step through a routine induction so you learn how to use the program.AnesthesiaOpen Anesthesia Module
Difficult intubation in a patient with asthmaCase 10 - 53 year old obese male for colon resectionIntubate awake and risk bronchospasm, or intubate asleep and risk losing the airway?AnesthesiaOpen Anesthesia Module
Anesthesia in patient with congestive heart failureCase 11 - 45 year old female for craniotomyThis patient has a brain tumor and has had treatment with adriamycin.AnesthesiaOpen Anesthesia Module
Cor pulmonaleCase 12 - 54 year old with cor pulmonale for emergency laparotomyThe patient has severe chronic COPD with pulmonary hypertension and right ventricular failure.AnesthesiaOpen Anesthesia Module
PheochromocytomaCase 13 - 40 year old for excision of pheochromocytomaExtreme hypertension will occur during this case. Best management is alpha-blockade and fluid replacement.AnesthesiaOpen Anesthesia Module
ThyrotoxicosisCase 14 - 34 year old for partial thyroidectomyThe patient will develop thyroid storm during this case with tachycardia, hypertension and hyperthermia. You will have the opportunity to distinguish thyrotoxicosis from malignant hyperthermia and manage the crisis.AnesthesiaOpen Anesthesia Module
Venous air embolismCase 15 - 60 year old for resection of posterior fossa tumorDuring the surgery the patient will become suddenly tachycardic, hypotensive, end-tidal CO2 decreases, CVP increases. If you dont quickly perform the appropriate maneuvers, the patient will arrest.AnesthesiaOpen Anesthesia Module
Paradoxical air embolismCase 16 - 44 year old for resection of tumor in cerebellar-pontine angleAir from an air embolism enters the left-sided circulation. Air in the coronary arteries leads to severe myocardial ischemia and left ventricular dysfunction.AnesthesiaOpen Anesthesia Module
Pulmonary embolismCase 17 - 48 year old female for cholecystectomyThis patient was immobile for two weeks prior to cholecystectomy and has a large PE during the case. Oxygenation, ventilation, fluid administration, inotropic support are needed. Intra-operative heparin administration is needed to prevent a second catastrophic PE.AnesthesiaOpen Anesthesia Module
Intubated but hard to ventilateCase 18 - 51 year old for emergency exploratory laparotomyAfter intubation the patient will become hard to ventilate. It is necessary to work through the differential diagnosis of intubated but hard to ventilate. The cause in this case is endobronchial intubation.AnesthesiaOpen Anesthesia Module
Intubated but difficult to ventilateCase 19 - 53 year old for emergency exploratory laparotomyThis trauma patient becomes difficult to ventilate after intubation and positive pressure ventilation. The cause is a pneumothorax which must be decompressed.AnesthesiaOpen Anesthesia Module
Rapid sequence inductionCase 2 - 27 year old with fractured humerusYou must perform a rapid sequence induction in this patient with a full stomach.AnesthesiaOpen Anesthesia Module
Difficult airway and increased ICPCase 20 - 21 yr old male with increased ICP for drainage of subdural hematomaInduce anesthesia and lose the airway or intubate awake and risk worsening the high ICP?AnesthesiaOpen Anesthesia Module
Rapid sequence induction with eye injuryCase 21 - 24 yr old male with penetrating eye injury and full stomachCan succinylcholine be used to facilitate rapid intubation?AnesthesiaOpen Anesthesia Module
Diabetic ketoacidosisCase 22 - 22 year old with septic knee and diabetic ketoacidosisThis patient must have emergent surgery despite being in diabetic ketoacidosis. You must replace intravascular fluids, administer insulin, monitor and treat electrolyte disturbances.AnesthesiaOpen Anesthesia Module
Latex allergyCase 23 - 34 year old male for multiple dental extractionsAfter the procedure starts, the patient becomes markedly tachycardic and hypotensive. You must treat the severe allergic reaction.AnesthesiaOpen Anesthesia Module
Redman syndromeCase 24 - 54 year old for axillary node biopsyThe vancomycin is inadvertantly administered very quickly. The patient develops Redman Syndrome. Unfortunately the nice red color becomes an ashen gray as the patient loses his blood pressure and perfusion.AnesthesiaOpen Anesthesia Module
Fluid resuscitation of the critically-ill premieCase 25 - 8 day old premature infant for laparotomyThis patient has Necrotizing EnteroColitis. You must replace intravascular fluids prior to administering anesthesia.AnesthesiaOpen Anesthesia Module
High ICPCase 26 - 4 year old with head injuryYou must apply the appropriate anesthetic techniques to avoid tight brain syndrome. Use endotracheal intubation, hyperventilation, mannitol, elevation of the head 30 degrees, appropriate isotonic fluids, avoid hypoxia and hyperglycemia.AnesthesiaOpen Anesthesia Module
Sleep apneaCase 27 - 4 year old for tonsillectomy and adenoidectomySecure the airway with fiberoptic intubation with maintenance of spontaneous ventilation.AnesthesiaOpen Anesthesia Module
Malignant hyperthermiaCase 28 - 4 year old for myringotomy and tubesYou can trigger MH in this case to rehearse diagnosis and treatment, or you can practice administering a non-triggering anesthetic technique.AnesthesiaOpen Anesthesia Module
PreeclampsiaCase 29 - 23 year old preeclamptic for induction of labor followed by Cesarean deliveryThis G1P0 at 30 weeks estimated gestational age is receiving an oxytocin infusion to induce labor because of worsening preeclampsia and concerns over fetal well-being. The obstetrician decides immediate Cesarean delivery is necessary due to decelerations on the FHR monitor. You must replace intravenous fluids, secure the airway, and avoid major swings in blood pressure.AnesthesiaOpen Anesthesia Module
Rapid sequence induction in a hypovolemic patientCase 3 - 86 year old with fractured hipIn order to avoid severe hypotension, you should replace intravascular volume before the rapid sequence induction.AnesthesiaOpen Anesthesia Module
EclampsiaCase 30 - 19 year old eclamptic for urgent Cesarean sectionThis patient has eclampsia and HELLP syndrome.AnesthesiaOpen Anesthesia Module
Post-partum hemorrhageCase 31 - 32 year old G8P5 with post-partum hemorrhageThe uterus inverts following delivery with massive blood loss. It is necessary to provide deep inhalation anesthesia to facilitate reinsertion of the uterus.AnesthesiaOpen Anesthesia Module
Anesthetic implications for the pregnant patientCase 32 - 32 yr old at 24 weeks gestation for intracerebral aneurysm clippingYou must deliver an anesthetic to a pregnant patient. Avoid teratogenic drugs, avoid intrauterine hypoxia, avoid premature labor.AnesthesiaOpen Anesthesia Module
Esophageal intubationCase 4 - 44 year old for laparoscopic cholecystectomyThe endotracheal tube accidentally slides into the wrong place when you intubate.AnesthesiaOpen Anesthesia Module
BronchospasmCase 5 - 16 year old for repair open femur fractureAfter intubation, the patient becomes difficult to ventilate. You must rule out causes other than bronchospasm.AnesthesiaOpen Anesthesia Module
AnaphylaxisCase 6 - 22 year old for appendectomyMake the diagnosis, then secure the airway, administer liters of intravenous fluids, and titrate epinephrine.AnesthesiaOpen Anesthesia Module
Myocardial ischemiaCase 7 - 67 year old for femoral-popliteal bypassThis is a straightforward case involving ST segment changes. Raise the blood pressure with phenylephrine, lower the heart rate with esmolol, and titrate nitroglycerin.AnesthesiaOpen Anesthesia Module
Malignant hyperthermiaCase 8 - 32 year old for total abdominal hysterectomyThis is a simulation of a case that was reported in the Can Anaes Soc J 1966; 13: 437-442. You can watch the evolution of a case of malignant hyperthermia. Review management of the acute crisis or administer a non-triggering anesthetic.AnesthesiaOpen Anesthesia Module
Aortic stenosisCase 9 - 74 year old with aortic stenosis for retropubic prostatectomyMaintain adequate preload, keep the heart rate down and the blood pressure up.AnesthesiaOpen Anesthesia Module
Traumatic brain injuryCase 1 - 40 year old assault victimThis patient has suffered a traumatic brain injury with declining mental status - It is important to quickly recognize the mechanism of injury and establish a diagnosis while maintaining patency of the airway and executing appropriate treatments for ICH.Critical CareOpen Critical Care Module
Diabetic ketoacidosisCase 2 - 32 year old diabetic with septic kneeThis patient has diabetic ketoacidosis. It is essential to correct the fluid and electrolyte imbalances associated with diabetic ketoacidosis slowly, over a few hours. In this simulation you need to replace intravascular volume, administer insulin, and monitor glucose, acidosis, potassium and phsophate. For this simulation you can replace the fluids in a few minutes even though in clinical practice the fluid and electrolyte imbalance would be corrected over 2 hours.Critical CareOpen Critical Care Module
AnaphylaxisCase 3 - 22 year old female with urinary tract infectionThis patient has a history of hay fever and penicillin allergy so there is a slightly increased risk for an allergic reaction.Critical CareOpen Critical Care Module
Severe episode of anginaCase 4 - 53 year old with chest painThis patient had a fairly recent myocardial infarction and had continuing angina in a stable pattern. Dipyridamole-thallium scan showed two areas of myocardium still at risk. The patient refuses cardiac cath or surgical intervention so we are limited to medical management of his coronary artery disease. He presents in the Emergency Department today with a more intense episode of chest pain today. Medical management with a beta-blocker, calcium-channel blocker and nitrates needs further adjustment.Critical CareOpen Critical Care Module
TraumaCase 5 - 46 year old male involved in a motor vehicle accidentThis patients history, physical exam, and laboratory studies all indicate hypovolemia. The presence of a scalp laceration suggest head trauma. Since the patient is not moving his lower extremities, injury of the spinal cord should be suspected.Critical CareOpen Critical Care Module
Trauma in pregnant patientCase 1 - 25 year old pregnant female involved in motor vehicle accidentThe patient is a 25 year old female status-post motor vehicle accident (MVA) arrives to ER by EMS call. In route she told the paramedics that she is 8 months pregnant. The OB service received the trauma call.ObstetricsOpen Obstetrics Module
Trauma requiring surgery in pregnant patientCase 2 - 30 year old pregnant female with femur fracture30 year old female status-post motor vehicle accident (MVA) arrives to ER by EMS. Restrained passenger, collision at about 50 mph. At scene told EMS that she was pregnant, and then became hysterical, unable to answer questions. There is an obvious open left femur fracture.ObstetricsOpen Obstetrics Module
Cardiac arrest in pregnant patientCase 3 - 19 year old pulseless pregnant female19 year old female status-post motor vehicle accident (MVA) arrives to ER by EMS. The patient was an unrestrained passenger, collision at about 50 mph. At scene told EMS that she was pregnant, and then became lethargic and unable to answer questions.ObstetricsOpen Obstetrics Module
Placental abruptionCase 4 - 27 year old G2P1 with placental abruptionThe patient is a 27 year old G2P1 with placental abruption. She presents at 33 weeks gestation.ObstetricsOpen Obstetrics Module
Postpartum hemorrhageCase 5 - 29 year old G1P1 with postpartum hemorrhageThe patient is a 29 year old G1P1 who develops excessive uterine bleeding after the vaginal delivery of twins.ObstetricsOpen Obstetrics Module
Postpartum hemorrhageCase 6 - 30 year old G1P1 with postpartum hemorrhageThe patient is a 30 year old G1P1 who develops excessive uterine bleeding after the vaginal delivery of twins.ObstetricsOpen Obstetrics Module
Ventricular fibrillationCase 1 - A 2 year old with a flu-like illnessCPR 5 cycles, defib (2 J/kg), CPR 5 cycles, defib (4 J/kg).PALSOpen PALS Module
Tachycardia - Supraventricular tachycardiaCase 10 - A fussy babySince the pulse is strong you can try adenosine if you can quickly establish IV or IO access.PALSOpen PALS Module
Tachycardia - Supraventricular tachycardiaCase 11 - A 4 year old reacts to her asthma medicationSince adenosine may worsen bronchospasm, try amiodarone or procainamide for stable SVT in children with reactive airway disease.PALSOpen PALS Module
Tachycardia - Wolff-Parkinson-White syndromeCase 12 - A 3 year old with a racing heartbeatAdenosine may cause SVT to degenrate to VFib in a child with WPW. Consult a pediatric cardiologist if possible, and prepare for electrical cardioversion. If stable you can try amiodarone or procainamide infusion.PALSOpen PALS Module
Ventricular fibrillationCase 2 - A 2 year old becomes unresponsive on the Pediatrics wardCPR 5 cycles, defib (2 J/kg), CPR 5 cycles, defib (4 J/kg). Add epinephrine and defib again.PALSOpen PALS Module
Ventricular fibrillationCase 3 - A 4 year old arrests on the Pediatrics wardAfter epinephrine, try amiodarone and defib again.PALSOpen PALS Module
Ventricular fibrillation - Imipramine toxicityCase 4 - A 5 year old takes her brothers medicineIn addition to the usual treatment for ventricular fibrillation, consider sodium bicarbonate in the treatment of imipramine toxicity.PALSOpen PALS Module
Pulseless electrical activityCase 5 - A 2 year old victim of MVACPR, intubate, intravenous fluid boluses, epinephrine.PALSOpen PALS Module
Pulseless electrical activity - AnaphylaxisCase 6 - A 5 year old with difficulty breathingYou must intubate immediately to provide a clear airway. You must administered several large boluses of intravenous fluids, and you must administer epinephrine.PALSOpen PALS Module
BradycardiaCase 7 - A 1 month old with respiratory illnessIn children, hypoxia often results in severe bradycardia. Correct the hypoxia. Administer epinephrine as needed. Atropine may be helpful if a vagal mechanism is present.PALSOpen PALS Module
BradycardiaCase 8 - A 3 year old takes grandmas medicineThis patient was lethargic and hypoxic on initial assessment. Start by reversing hypoxia and add epinephrine. You should consider transcutaneous pacing for this case.PALSOpen PALS Module
Tachycardia - Supraventricular TachycardiaCase 9 - A 3 month old is suddenly unresponsiveSince this patient is unstable, use electrical cardioversion.PALSOpen PALS Module
Septic shockCase 1 - Lethargic 3 year old with feverIt is important to recognize the need for Early Goal-Directed Therapy. Specifically, the learner should control the airway, rapidly restore circulating volume, and administer inotropes and pressors as needed for patients with sepsis. Starting the appropriate antibiotics is a secondary concern.PediatricsOpen Pediatrics Module
Status epilepticusCase 2 - 12 month old female in status epilepticusIdentify and rapidly treat pediatric status epilepticus, understand the importance of minimizing secondary injury, then treat with anti-epileptics, and then determine the exact etiology of the seizure(s).PediatricsOpen Pediatrics Module
Multiple traumaCase 3 - 3 year old multiple trauma victimThis patients history, physical exam, and laboratory studies all indicate severe hypovolemia. Fluid replacement prior to administering sedative drugs for intubation is critical. Inadequate fluid replacement may lead to hypotension on induction.PediatricsOpen Pediatrics Module
Diabetic ketoacidosisCase 4 - 2 year old with vomiting and weight lossRapidly diagnose this child with diabetic ketoacidosis and depressed mental status. Restore circulating volume with isotonic fluids, begin continuous insulin infusion therapy.PediatricsOpen Pediatrics Module
Near-drowningCase 5 - 18 month old female with a near-drowning eventProtect the cervical spine while establishing a patent airway with adequate oxygenation and ventilation, restore adequate intravascular volume and perfusion, warm to 32-34 degrees C, manage complications such as seizures, dysrhythmias, hemodynamic instability and ARDS.PediatricsOpen Pediatrics Module
MeningitisCase 6 - 4 year old male with meningitis and altered mental statusEstablish a patent airway with adequate oxygenation and ventilation, choose a sedative and paralytic that do not increase ICP, consider lidocaine as an adjunct to intubation, elevate and position the head midline, minimize secondary inury by normalizing temperature, vascular volume and blood pressure, and serum glucose. Give mannitol and/or hypertonic saline. Treat seizures aggressively with both short and long-acting antiepileptics. Obtain emergent neuroimaging and neurosurgical consultation.PediatricsOpen Pediatrics Module
ACLS ECG Rhythm TrainingECG rhythmsProvides practice identifying ECG rhythms as they sweep across the screen. This program covers all the rhythms necessary for ACLS training.Rhythm SimOpen Rhythm Sim Module
Titration of medications and monitoringEndoscopy Case 1 - 54 year old male for colonoscopy for polypsRoutine colonoscopy for adenomatous polyps. The patient also has hypertension, mild cirrhosis and non-insulin dependent diabetes mellitus. Sedate this anxious patient with midazolam for the procedure. Fentanyl can also be administered but since the procedure is not painful, only 50-100 mcg should be needed. Monitor respiration and oxygen saturation.SedationOpen Sedation Module
Respiratory depressionEndoscopy Case 2 - 4 year old girl for upper endoscopy for suspected refluxThe patient has recurrent abdominal pain, chronic vomiting and hematemesis. She is scheduled for upper endoscopy to rule out gastroesophageal reflux. This patient is sensitive to the respiratory depressant effects of the sedative agents and will become apneic.SedationOpen Sedation Module
AspirationEndoscopy Case 3 - 18 year old male for esophagogastroduodenoscopy for ulcerThe patient complains of abdominal pain and has melena. He has been taking ibuprofen for a football injury. Esophagogastroduodenoscopy is scheduled to rule out an ulcer. The best management of aspiration is to avoid it by following the NPO guuidelines. In this simulation the patient is simply choking on secretions. Stop the procedure, suction promptly to clear the airway, administer supplemental oxygen, listen to the breath sounds. Then resume the procedure since all is well.SedationOpen Sedation Module
BradycardiaEndoscopy Case 4 - 6 year old boy for colonoscopy to rule out ulcerative colitisThis patient has an anterior mediastinal mass. He could develop airway obstruction with deep sedation. During the case this patient will develoop significant bradycardia.SedationOpen Sedation Module
Hypertensive crisisEndoscopy Case 5 - 82 year old for colonoscopy for rectal bleedingThe patient has bright red blood per rectum. She is very anxious about this procedure. During the case the patient will experience a sudden onset of tachycardia and increased blood pressure, most likely due to pain.SedationOpen Sedation Module
AnaphylaxisEndoscopy Case 6 - 25 year old anxious male for colonoscopy for cancer screeningThe patient has a family history of adenomatous polyposis. Father died of colon cancer at age 35. The patient also has a history of asthma and is quite anxious. During the case the patient will develop sudden onset of tachycardia and hypotension with other signs of sever allergic reaction.SedationOpen Sedation Module
Myocardial ischemiaEndoscopy Case 7 - 57 year old male for esophagogastroduodenoscopy for dysphagiaThe patient has a two month history of solid food dysphagia. He denies abdominal pain except for occasional reflux after spicy foods. The patient has coronary artery disease status-post 4 vessel bypass 2 years ago. Monitor heart rate and blood pressure closely. Avoid tachycardia and hypotension.SedationOpen Sedation Module
AgitationEndoscopy Case 8 - 4 year old girl for upper endoscopy for suspected refluxThe patient has recurrent abdominal pain, chronic vomiting and hematemesis. She is scheduled for upper endoscopy to rule out gastroesophageal reflux.SedationOpen Sedation Module
Titration of medications and monitoring in patient with aortic stenosisOral Surgery Case 1 - 48 year old woman with aortic stenosis for tooth extractionThis patient has severe aortic stenosis which predisposes her to hypotension, myocardial ischemia and stroke. If she does become hypotensive she will probably be quite difficult to resuscitate.SedationOpen Sedation Module
Respiratory depressionOral Surgery Case 2 - 4 year old girl for composite crownsThe patient has very poor diet and poor oral hygiene. She requires multiple composite crowns.SedationOpen Sedation Module
AspirationOral Surgery Case 3 - 15 year old female for extraction of premolars for orthodonticsThe patient is otherwise in excellent health. She states that she would like to drift off to sleep and wake up when its over.SedationOpen Sedation Module
BradycardiaOral Surgery Case 4 - 22 year old phobic male for fillings of molar teethThe patient is quite anxious, but is otherwise healthy.SedationOpen Sedation Module
Hypertensive crisisOral Surgery Case 5 - 78 year old female for full mouth extractionsThe patient requires extraction of several teeth. She is quite nervous and would like to sleep through the procedure.SedationOpen Sedation Module
AnaphylaxisOral Surgery Case 6 - 16 year old male extraction of third molarsThis patient has a history of hay fever and drug allergy so there is a slightly increased risk for an allergic reaction.SedationOpen Sedation Module
Myocardial ischemiaOral Surgery Case 7 - 45 year old male with coronary artery disease for root canalThe patient has coronary artery disease. He is very anxious about this procedure and gets chest pain just thinking about it. He also has symptoms of esophageal reflux.SedationOpen Sedation Module
AgitationOral Surgery Case 8 - 6 year old boy for pulp therapy for tooth TThe patient has poor oral hygiene, eats lots of candy, and drinks soda regularly. He also hates dentists.SedationOpen Sedation Module
Titration of medications and monitoringRadiology Case 1 - 52 year old male paraplegic for MRI of spinal cord syrinxThis patient has had several scans in the past and prefers to be sedated to avoid feelings of claustrophobia. He has poor neck extension which may make him more difficult to intubate. His past medical history is otherwise unremarkable.SedationOpen Sedation Module
Respiratory depressionRadiology Case 2 - 4 year old girl with headaches for head CTThis patient has asthma and is allergic to shrimp and lobster. There is increased chance for an allergic reaction with iodinated contrast media.SedationOpen Sedation Module
AspirationRadiology Case 3 - 22 year old female with pelvic fracture for pelvic angiogramThis patient has been hypotensive and may still be hypovolemic, predisposing to hypotension. The patient has a full stomach and is at high risk for aspiration of gastric contents with sedation. The patient should only be given very small amounts of sedative medications or the case should be referred to an anesthesiologist.SedationOpen Sedation Module
BradycardiaRadiology Case 4 - 6 year old boy with anterior mediastinal mass for chest CTThis patient has an anterior mediastinal mass. He could develop airway obstruction with deep sedation.SedationOpen Sedation Module
Hypertensive crisisRadiology Case 5 - 42 year old woman with hypertension for abdominal CTThis patient has severe hypertension and nausea.SedationOpen Sedation Module
AnaphylaxisRadiology Case 6 - 16 year old male with hemiparesis for brain angiogramThis patient has new onset hemiparesis and is scheduled for brain angiogram. The patient has no other previous illnesses. Since he is allergic to shrimp, he is at increased risk of a reaction to iodinated contrast media.SedationOpen Sedation Module
Myocardial ischemiaRadiology Case 7 - 54 year old male with possible AAA for abdominal CTThis patient is scheduled for abdominal CT scan to rule out aortic aneurysm. He has coronary artery disease and chronic obstructive pulmonary disease. Monitor cardiac status closely in this unstable patient.SedationOpen Sedation Module
AgitationRadiology Case 8 - 7 year old girl with mental status changes for head CTThe patient has no other previous illnesses. If the patient has elevated intracranial pressure, sedation could lead to hypoventilation, and greatly increased intracranial pressure.SedationOpen Sedation Module
Titration of medications and monitoringSurgery Case 1 - 62 year old female for breast biopsyThis patient otherwise healthy patient is quite anxious about this procedure.SedationOpen Sedation Module
Respiratory depressionSurgery Case 2 - 4 year old hysterical girl for suturing of lacerationThe patient is crying and screaming and is creating quite a scene. The laceration on her leg will require 6-8 sutures. The procedure should take just a few minutes.SedationOpen Sedation Module
AspirationSurgery Case 3 - 19 year old male for excision of inclusion cystThe patient has an epidermoid inclusion cyst on his upper abdomen. He is hyperventilating at the thought of surgery.SedationOpen Sedation Module
BradycardiaSurgery Case 4 - 78 year old male for cataract surgeryThe patient would like to be sedated for his procedure. He has coronary artery disease and gets chest pain when he is excited.SedationOpen Sedation Module
Hypertensive crisisSurgery Case 5 - 66 year old female for excision of breast lumpThe patient has a strong family history of breast cancer and is extremely distressed about this procedure.SedationOpen Sedation Module
AnaphylaxisSurgery Case 6 - 15 year old female for excision of lipomaThe patient has a 3 cm lipoma on her thigh. She is quite anxious and states that she would like to drift off to sleep and wake up when its over.SedationOpen Sedation Module
Myocardial ischemiaSurgery Case 7 - 48 year old male with coronary artery disease for vasectomyThis father of three does not wish to have more children. He is very sure about this but he is quite anxious about the procedure.SedationOpen Sedation Module
AgitationSurgery Case 8 - 8 year old boy with paronychia of three fingersThe patient is a chronic nail-biter and has developed multiple subungual abscesses requiring incision and drainage. The patient is in a great deal of pain and is very anxious.SedationOpen Sedation Module