Disseminated Intravascular Coagulation in a High-Risk Pediatric Oncology Patient: A Pediatric Simulation Case for Residents and Fellows
Year: 2025
Type: article
Abstract: Introduction: Disseminated intravascular coagulation (DIC) is an acquired life-threatening condition defined by systemic coagulation imbalance.Due to the high mortality associated with this condition, it is paramount that providers quickly recognize key clinical signs and laboratory value changes.Methods: This simulation was designed for pediatric residents, fellows, or other providers who treat patients at risk for DIC.The case was a 6-year-old boy with newly diagnosed leukemia admitted to the oncology service for induction chemotherapy who presents with a nosebleed, then develops profuse, multisite bleeding consistent with a diagnosis of DIC.The goals for the team were to treat the epistaxis, verbalize DIC as the diagnosis, and address hemodynamic instability due to DIC.Directly following completion of the scenario, a debriefing session was facilitated using the PEARLS (Promoting Excellence and Reflective Learning) method.A pre-and postsimulation survey was completed that consisted of participant self-assessment of their ability to achieve each of the three educational objectives, where they rated their confidence in managing epistaxis, recognizing DIC, and achieving hemodynamic stability on a 3-point scale (1 = almost there, 2 = proficient, 3 = mastery).Results: Of the 91 simulation participants, which included pediatric and pharmacy residents, 89 completed the survey.The median competency score significantly increased by 0.49 points (99% CI, 0.37 to 0.61) from preto postsimulation (p < .001).Discussion: This simulation serves as a learning tool for teaching the clinical and laboratory presentation of DIC, guiding management of epistaxis, and addressing hemodynamic instability.
Source: MedEdPORTAL
Authors: Kimberly Walter, Sonal Sian, Gabriela Ocampo, Jeanne Carey, Kirk Atkinson, Kaitlin Kennedy, Khawar Nawaz, Ngoc Van Horn
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417262030