<p> The Johns Hopkins Medicine Simulation Center Scenario Planning Worksheet</p><p>Step 1: General Scenario Information</p><p>Developer Name: Department: Case Name: Date: Target Duration (min): Intended Learners: </p><p>Case Description (describe your patient as a case presentation-Information for Facilitator ONLY): </p><p>Step 2: Learning Objectives At the end of this scenario, participants will be able to: 1) 2) 3) 4) 5)</p><p>Step 3: Patient Information</p><p>Patient Name: Gender: Weight: Height: Clinical Setting: Case Description for Participants: (SBAR)</p><p>Complaint: Allergies: Medications: Past Medical History: Social History: Events Leading to Current Condition: Temperature: Labs:</p><p>Step 4: Scenario Algorithm</p><p>Manikin Capabilities/Features/Options</p><p>Airway Options Vocal Sounds: Breath Sounds: Circulation: Heart Sounds: Bowel Sounds:  Normal Airway The manikins have the  Normal breathing  Normal  Describe types of  Normal Bowel  Tongue Edema, capability to replicate vocal  Abnormal BrS Circulation heart sounds, and Sounds  Cervical Range sounds. There are preloaded  Differential sounds  Weak Pulses, location (if  Hypoactive, sounds, but if you want of Motion R vs L, apices vs.  Absent important)  Hyperactive, specific statements please bases, posterior vs. Pulses (PEA)  Trismus type them below and we will  Borborygmus anterior  Pharyngeal simulate and upload them i.e. Obstruction coughing or my chest hurts…  Laryngospasm</p><p>Manikin Initial Peripherals (Please BOLD Your Answer)</p><p>IV placed? YES NO Arterial Line Currently placed? YES NO ECG placed on the patient? YES NO Patient currently placed on O2? YES NO Is the patient on a ventilator? YES NO Does the patient have an NG tube? YES NO</p><p>Describe any other pertinent initial set ups for manikin (type of bed, location in room, moulage, any other important information)-A photo would be ideal</p><p>Scenario Stage Pati Simulator Expected Interventions (Participant Simulator Scripted Participant ent Parameters Actions) Response (Confederate) Response Con (Bold which to ditio display on Monitor) n Initial Stage Gen: Vitals: Airwa ECG: y: HR: Breat hing: BP: Circul RR: ation: SpO2: Disab ETCO2: ility: Temp: Expo sure: Pt Condition: Other: Stage 2 Chan Vitals: ge in Cond ECG: ition: HR: Labs: BP: X- RR: rays, other SpO2: Diag ETCO2: nosti cs: Temp: Pt Condition: Other: Stage 3 Vitals: ECG: HR: BP: RR: SpO2: ETCO2: Temp: Pt Condition: Other: Stage 4 Vitals: ECG: HR: BP: RR: SpO2: ETCO2: Temp: Pt Condition: Other: Stage 5 Vitals: ECG: HR: BP: RR: SpO2: ETCO2: Temp: Pt Condition: Other:</p><p>Step 5: Additional Manikin Capabilities (BOLD if requesting or need additional information—a simulation staff member will contact you.)</p><p> Intubation (oral/nasal)  Supplemental O2  needle decompression  chest tube placement  IV placement (one side vs. two sided)  Arterial line moulage (does it need to work?)  Foley catheter placement  Surgical cricothyrotomy  Wounds/injury simulation  Profuse bleeding simulations  Blood pressure cuff monitoring  SpO2 monitoring cable  NG tube placement  Tracheotomy placement  Ability to electronically post ECG, Chest X-ray, Lab Values and other media upon request  Seizure  Intraosseus needle placement (and location)</p><p>Key Debriefing Points</p>