Stroke Module
Hospital Scene C, Act 1
Scene Description & transition from previous scene:
Patient is in CT angiogram room waiting for secondary test of CT angiogram.
To be added to protocol:
To be added to Patient History:
1. Perform CT angiogram
2. Determine course of treatment
Computer Command Center:
Run CT Angiogram
Description/Actions:
Student clicks on “Run CT Angiogram” and video pops up, showing a patient having a CT
angiogram scan. Move to Act 2.
To be added to Electronic Medical Record:
Description of how and why CT Angiograms are done.
To be added to Dr. Notes:
Stroke Module
Hospital Scene C, Act 2
Scene Description & transition from previous scene:
Patient is in CT angiogram room, awaiting results of CT angiogram.
To be added to protocol:
To be added to Patient History:
1. Perform CT angiogram
2. Determine course of treatment
Computer Command Center:
Aneurysm in Anterior Communicating Artery
Choose a course of treatment:
a.
Clip the aneurysm (Learn more about this procedure in the EMR)
b.
Coil the aneurysm (Learn more about this procedure in the EMR)
Description/Actions:
CT angiogram results show that the patient has an aneurysm in the anterior communicating
artery. Student must choose to either clip or coil the artery.
If the student chooses a, the message should read “This procedure is highly invasive and should
only be done when the aneurysm is located close to the surface of the brain and on younger
patients. Please think carefully before proceeding with this procedure on this patient”. The
student then is returned to “Choose a course of treatment”.
If the student chooses b, the message should read “Correct! This procedure is much less
invasive and a better choice for this patient. Go forward with your treatment of this patient.”
To be added to Electronic Medical Record:
-
Brain blood vessel anatomy
Information about clipping aneurysms
Information about coiling aneurysms
To be added to Dr. Notes:
CT angiogram shows aneurysm in the anterior communicating artery.
Aneurysm in Anterior Communicating Artery
Have decided to coil/embolyze the aneurysm due to patient’s age and lack of invasiveness of
this procedure.
Stroke Module
Hospital Scene C, Act 3
Scene Description & transition from previous scene:
Patient is in CT angiogram room awaiting the coiling procedure..
To be added to protocol:
1. Perform embolization (coiling) on the
aneurysm.
2. Send patient to ICU.
Computer Command Center:
Insert a coil into the aneurysm.
To be added to Patient History:
Description/Actions:
A. Student clicks on “coil the aneurysm”.
B. Coiling procedure video or simulation is shown.
To be added to Electronic Medical Record:
Video of emoblization (coiling) process.
To be added to Dr. Notes:
Stroke Module
Hospital Scene C, Act 4
Scene Description & transition from previous scene:
Patient is in CT angiogram room following embolization procedure.
To be added to protocol:
To be added to Patient History:
1. Perform embolization (coiling) on the
aneurysm.
2. Send patient to ICU.
Computer Command Center:
Coiling of aneurysm was successful.
Send patient to ICU with orders for HHH therapy and vasospasm monitoring.
Description/Actions:
Coiled aneurysm appears on screen and student then clicks on “Send patient to ICU”. At that
time, a box appears that says “Congratulations! You have successfully treated Mr. Jones within
the 3 hour time window necessary. If you have scored a __________ or higher, you are still in
the running to become Chief of Staff – great job! If you have scored lower than a _______,
perhaps the next stroke patient to come through the doors of St. Normal Hospital will have
better results. Also, please realize that Mr. Jones’ journey is not over. He will have a 10-14 day
stay in the ICU (where the rate of mortality from strokes is very high 2-12 days following the
initial stroke) and then undergo physical therapy. “
To be added to Electronic Medical Record:
-
HHH therapy
Vasospasms (causes and treatments)
To be added to Dr. Notes: Aneurysm successfully coiled.
Sent patient to ICU for recovery. Ordered HHH therapy and monitoring for vasospasms.