lOMoARcPSD|14985576
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
Session History (/dashboard) / George, Seizure and Hypoglycemia [SNR114US]
George, Seizure and Hypoglycemia [SNR114US]
Learning Objectives
Diagnosis
Seizure secondary to hypoglycemia with a recent history of unstable blood glucose readings.
Case Summary
Drowsy and confused patient with low blood glucose readings.
Tonic-clonic seizure secondary to hypoglycemia.
Hypoglycemia likely precipitated by not adjusting insulin regimen correctly due to social factors.
No source of infection or other intracranial cause for seizure evident.
Clinical Findings
Confused, seizing, then drowsy
Low blood glucose
High lactate post-seizure
Technical Skills
Assessment
Complete a full set of vitals and document on EWS chart
Gain a collateral history (via medical record or call to next of kin)
Establish medical history (including type 1 diabetes)
Establish medication history (including insulin use)
Ascertain allergy status
Perform reassessment during and after seizure
Initial Investigations
1/19
, lOMoARcPSD|14985576
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
Measure blood glucose (via bloods, blood gas or capillary blood glucose)
Take blood tests (for electrolytes and infection markers)
Take blood gas
Management
Perform SBAR report and request urgent medical review
Insert IV access (when possible)
Deliver oxygen (to maintain saturations above 94%)
Administer all drugs (prescribed by medical team)
Use appropriate adjuncts to manage airway
Non-technical Skills
Make rational, timely clinical decisions
Effectively communicate with patient and team
Appropriately utilize other team members
Maintain patient safety and comfort
Apply clinical knowledge and adapt to changes in patient condition
Escalate and refer appropriately
What went well - critical aspects
Verify name and date of birth
You verified your patient's name and date of birth
Show rationale
Person-Centered Care Quality & Safety
00:54
5 Rights of medication administration
2/19
, lOMoARcPSD|14985576
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
You utilized the 5 rights of medication administration before
administering medication to your patient
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
00:54
Allergies
You correctly asked about allergies, discovering George's
severe penicillin allergy
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
00:56
Allergy assessment before medications
You correctly assessed the patient's allergy status prior to
giving medications
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
3/19
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
Session History (/dashboard) / George, Seizure and Hypoglycemia [SNR114US]
George, Seizure and Hypoglycemia [SNR114US]
Learning Objectives
Diagnosis
Seizure secondary to hypoglycemia with a recent history of unstable blood glucose readings.
Case Summary
Drowsy and confused patient with low blood glucose readings.
Tonic-clonic seizure secondary to hypoglycemia.
Hypoglycemia likely precipitated by not adjusting insulin regimen correctly due to social factors.
No source of infection or other intracranial cause for seizure evident.
Clinical Findings
Confused, seizing, then drowsy
Low blood glucose
High lactate post-seizure
Technical Skills
Assessment
Complete a full set of vitals and document on EWS chart
Gain a collateral history (via medical record or call to next of kin)
Establish medical history (including type 1 diabetes)
Establish medication history (including insulin use)
Ascertain allergy status
Perform reassessment during and after seizure
Initial Investigations
1/19
, lOMoARcPSD|14985576
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
Measure blood glucose (via bloods, blood gas or capillary blood glucose)
Take blood tests (for electrolytes and infection markers)
Take blood gas
Management
Perform SBAR report and request urgent medical review
Insert IV access (when possible)
Deliver oxygen (to maintain saturations above 94%)
Administer all drugs (prescribed by medical team)
Use appropriate adjuncts to manage airway
Non-technical Skills
Make rational, timely clinical decisions
Effectively communicate with patient and team
Appropriately utilize other team members
Maintain patient safety and comfort
Apply clinical knowledge and adapt to changes in patient condition
Escalate and refer appropriately
What went well - critical aspects
Verify name and date of birth
You verified your patient's name and date of birth
Show rationale
Person-Centered Care Quality & Safety
00:54
5 Rights of medication administration
2/19
, lOMoARcPSD|14985576
George, Seizure and Hypoglycemia [SNR114US] | Oxford Medical Simulation - VR training for optimal patient care
You utilized the 5 rights of medication administration before
administering medication to your patient
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
00:54
Allergies
You correctly asked about allergies, discovering George's
severe penicillin allergy
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
00:56
Allergy assessment before medications
You correctly assessed the patient's allergy status prior to
giving medications
Show rationale
Person-Centered Care Knowledge for Practice
Systems-Based Practice Quality & Safety
Professionalism
3/19
