β受体阻滞剂的毒性。

Journal of education & teaching in emergency medicine Pub Date : 2025-07-31 eCollection Date: 2025-07-01 DOI:10.21980/J8WD3X
Amrita Vempati, P J Greene
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引用次数: 0

摘要

观众:这个模拟是为急诊医学(EM)住院医师(所有级别)和四年级医学生设计的。简介:β受体阻滞剂(BB)毒性在25种与死亡相关的物质中排名第七,心血管死亡率高达1.4%。服用BB过量的患者可能出现慢速心律失常、低血压、低血糖、精神状态改变和心源性休克鉴于急诊医生往往是第一个遇到这样的病人,急诊学习者需要精通管理BB毒性的各个方面。教育目标:在课程结束时,学习者将能够:1)管理低血压和心动过缓的患者,同时保持广泛的差异;2)利用超声评估低血压的原因;3)回顾何时开始使用血管加压剂和β受体阻滞剂毒性的一线药物;4)讨论BB毒性的治疗算法,包括大剂量胰岛素;5)讨论自杀的危险因素。教育方法:本次会议采用高保真模拟,然后进行深入的汇报。这项调查是在新兴市场第一年住院医师培训期间进行的,共有16名住院医师参加。该小组被分为两组:8名住院医生积极管理模拟病人,而其他8名观察。研究方法:在模拟和汇报之后,使用谷歌表格对参与者进行在线调查。调查包括以下问题:1)病例是否可信,2)病例的复杂性是否适中,3)该病例有助于提高医学知识和患者护理,4)我对未分化性低血压的管理更有信心,5)我对BB过量的管理更有信心,6)模拟环境让我有了真实的体验,7)模拟后的汇报有助于提高我的知识。问卷采用李克特量表收集。结果:10名参与者完成了会后调查。所有答复者都同意或强烈同意,该案例在加强学习、医学知识和病人护理技能方面是有效的。每个参与者都发现汇报会议是有价值的,并报告增加了管理未分化性低血压和BB毒性的信心。讨论:模拟会议有效地教育了参与者对BB毒性的管理,强化了低血糖、心动过缓和低血压治疗等关键概念。随着病例的发展,学习者被要求评估难治性低血压,并开始血管加压治疗和针对BB毒性的特异性治疗。总的来说,参与者发现模拟对学习BB过量的管理是有益的。主题:受体阻滞剂毒性,难治性低血压,心动过缓,毒理学,心理健康,精神病学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beta-Blocker Toxicity.

Audience: This simulation is intended to be used for emergency medicine (EM) residents (all levels) and 4th year medical students.

Introduction: Beta-blocker (BB) toxicity ranks seventh among the top 25 substances associated with fatalities, with a cardiovascular mortality rate of up to 1.4%.1,2 Patients with BB overdose may present with bradydysrhythmias, hypotension, hypoglycemia, altered mental status, and cardiogenic shock.3 Given that EM physicians are often the first to encounter such patients, EM learners need to be proficient in managing all aspects of BB toxicity.

Educational objectives: By the end of the session, learners will be able to: 1) manage a patient with hypotension, and bradycardia while maintaining a broad differential, 2) evaluate the causes of hypotension by utilizing ultrasound, 3) review when to initiate vasopressors and first-line agents for beta-blocker toxicity, 4) discuss treatment algorithm for BB toxicity including high-dose insulin and, 5) discuss the risk factors for suicide.

Educational methods: This session employed high-fidelity simulation followed by an in-depth debriefing. It was conducted during the orientation for first-year EM residents, with 16 residents participating. The group was divided into two cohorts: eight residents actively managed the simulated patient, while the other eight observed.

Research methods: Following the simulation and debriefing, participants were surveyed online using Google Form. The survey included the following questions: 1) the case was believable, 2) the case had right amount of complexity, 3) the case helped in improving medical knowledge and patient care, 4) I feel more confident in managing undifferentiated hypotension, 5) I feel more confident in managing BB overdose, 6) the simulation environment gave me a real-life experience and, 7) the debriefing session after simulation helped improve my knowledge. Responses were collected using a Likert scale.

Results: Ten participants completed the post-session survey. All respondents either agreed or strongly agreed that the case was effective in enhancing learning, medical knowledge, and patient care skills. Every participant found the debriefing session valuable and reported increased confidence in managing undifferentiated hypotension and BB toxicity.

Discussion: The simulation session effectively educated participants on the management of BB toxicity, reinforcing key concepts such as the treatment of hypoglycemia, bradycardia, and hypotension. As the case unfolded, learners were required to assess refractory hypotension and initiate vasopressor therapy and specific treatments for BB toxicity. Overall, participants found the simulation beneficial for learning the management of BB overdose.

Topics: Beta-blocker toxicity, refractory hypotension, bradycardia, toxicology, mental health, psychiatry.

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