Hospital Stroke Module

Scene B

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• Run Ct Scan

EMRProtocol Doctor Notes

1. Run Ct Scan

2. Confirm primary diagnosis

Description/Actions:

a. Student clicks on Scan button

b. Patient enters CT machine

c. Switch to Act 2

Help/Reference Materials:

How a CT scan works

Scene B, Act 1

Patient History

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• Diagnosis:

•A. Subarachnoid Hemorrhagic (SAH) stroke

•B. Non-subarchnoid Hemorrhagic (nSAH) stroke

Description/Actions:

a. CT results appear on computer along with diagnostic options

b. If student chooses SAH stroke, move to Act 3

c. If student choose nSAH stroke, a window should appear showing what a CT scan of an nSAH stroke looks like

Help/Reference Materials:

CT scan of nSAH stroke

How to read a CT scan

Normal brain CT

Scene B, Act 2

1. Run Ct Scan

2. Confirm primary diagnosis

Protocol EMR Patient HistoryProtocol

Doctor Notes Patient History

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EMRProtocol Doctor Notes

1. Run Ct Scan

2. Confirm primary diagnosis

3. Determine what is causing the bleed (VMT)

Help/Reference Materials:

Causes of hemorrhagic strokes and the corresponding treatments.

Scene B, Act 3

Patient History

What is causing thisbrain hemorrhage?

Based on your research, will you…

A. Send the patient for neurosurgery?B. Order a second diagnostic test?

Actions:

A. Student determines probably cause of hemorrhage by reading about causes of SAH stroke in VMT.

B. Student chooses desired course of action.

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EMRProtocol Doctor Notes

1. Run Ct Scan

2. Confirm primary diagnosis

3. Determine what is causing the bleed (VMT)

4. Order a second diagnostic test

Help/Reference Materials:

Definitions/examples of MRI, PET scans and CT angiograms with their commons uses.

Scene B, Act 4

Patient History

Secondary test options:

A. MRI B. PET scan C. CT angiogram

Actions:

A. Student chooses desired test to find aneurysm.

B. If chooses correctly, moves to Scene C

Dr. _______’s Notes

• Ordered CT Scan– Faster– Can find bleed in brain– Less expensive

Return to ER

How a CT Scan Works

• Return to ER

Dr. _______’s Notes

• Ordered CT Scan: faster, can find bleed in brain, less expensive

• Subarachnoid hemorrhagic (SAH) stroke diagnosed

Return to ER

Bleeding

EMR – Scene B, Act 2

• CT scan of nSAH stroke

• CT scan of SAH stroke

• How to read a CT scan

• Normal brain CT

• Descriptions of nSAH and SAH strokes

SAH stroke

• Correct! The bright white areas indicate a bleed in the subarachnoid space. Great job Dr _______! Proceed!

• Return to ER

Bleeding

nSAH Stroke

• CT scan of nSAH stroke

• Does your patient’s CT scan match this one? Try again!

• Your patient’s CT scan

• Return to ER

EMR – Scene B, Act 3

• Causes of SAH hemorrhagic strokes and their treatments

• Return to ER

Neurosurger for Mr. Jones?

• Sorry, Mr. Jones’s SAH stroke if probably due to an aneurysm since there is no recent trauma in his medical history. Therefore, surgery is not a good choice for him. Try again!

• Return to the ER

A second test for Mr. Jones?

• Correct! Mr. Jones’s SAH stroke if probably due to an aneurysm since there is no recent trauma in his medical history.

• Now, you must determine the best test for to find Mr. Jones’s aneurysm. Hurry, the clock is ticking!

• Return to the ER

Dr. Notes – Act 3

• SAH stroke is probably due to an aneurysm since there is no trauma in Mr. Jones’ recent patient history

EMR: Scene B, Act 4

• Definitions/examples of MRI w/common uses

• Definitions/examples of PET scan w/common uses

• Definitions/examples of CT angiogram w/common uses

• Return to ER

CT Angiogram for Mr. Jones?

• Correct! A CT Angiogram will allow you to find the location of the suspected angiogram. Proceed to the CT Angiogram room!

An MRI for Mr. Jones?

• This patient’s symptoms started over an hour ago and an MRI will take 45-60 minutes. This may not leave you enough time for treatment. Try again!

•

A PET scan for Mr. Jones?

• PET scans are normally used to show brain functioning, not cardiovascular anatomy. Try again!

Dr. ________’s Notes

• CT angiogram ordered in order to determine the location of the aneurysm. MRI rejected due to time issues and PET scan rejected because it would show brain functioning, not brain anatomy.