458 APPENDIXES Appendix C Scenario Name: A Pneumothorax in a Late Preterm Neonate Brief Summary: A neonate at 35 weeks’ gestational age with respiratory distress syndrome is intubated and receiving mechanical ventilation. The patient develops an acute pneumothorax. Learning Objectives Cognitive Technical Behavioral 1. Recognize the clinical signs of a pneumothorax. 2. Recognize the vital sign changes associated with a pneumothorax. 3. Identify the appropriate treatment of a pneumothorax. 1. Perform transillumination of the neonate’s chest. 2. Perform needle thoracentesis with aseptic technique. 3. Insert a chest tube. 4. Demonstrate the correct setup for a chest tube drainage system. 1. Call for help in a timely manner. 2. Demonstrate effective, clear, concise team communication, including Directed communication Closed-loop communication Staff handoffs 3. Assign roles and delegate responsibilities. 4. Demonstrate effective resource allocation. 5. Maintain situational awareness. Simulation Roles 1. Registered nurse (embedded participant): provides handoff of the patient to the team 2. Attending physician 3. Trainees (eg, residents, fellows) 4. Neonatal registered nurse 5. Neonatal respiratory therapists 6. Neonatal nurse practitioners 7. Pharmacist Note: An embedded participant is a person coached or scripted to play a role in the simulation, the goal of which is to help guide the scenario.1 Box C-1. NICU and Simulation Center Supplies Needed for In Situ Simulation NICU supplies Simulation center supplies Radiant warmer bed Resuscitation device with various-sized masks IV pole Intubation box (laryngoscope, laryngo- scope blades, LMA, CO2 detectors) Resuscitation (code) cart High-technology mannequin and monitor Electrocardiographic leads and pulse oximeter sensor ETTs (sizes 3.0F and 3.5F) IV tubing and fluids (bag of dextrose, 10%, in water solution) UVC (size 5.0F) Needle aspiration kit (30-mL syringe cleansing agent 24-, 22-, and 20-gauge needles with guidewire, connector tubing, and stopcock) Chest tubes (pigtail catheter/trocar) and chest tube drainage system Chest radiographs Chart (blank order sheets, code drug sheet, laboratory results) Abbreviations: CO2, carbon dioxide ETT, endotracheal tube IV, intravenous LMA, laryngeal mask airway NICU, neonatal intensive care unit UVC, umbilical venous catheter. NeoSim.indb 458 2/21/21 12:13 PM
Previous Page Next Page