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12 Ethics and Care at the End of Life

Scenario
Available for:

LLEAP and/or SimPad

       
    SimNewB
       
    SimNewB Classic
optimized for Optimized for:LLEAP and SimPad
Scenario

Learning Objectives

  • Perform a pre-resuscitation team briefing by reviewing risk factors, identifying the team leader, discussing possible scenarios, and assigning roles and responsibilities
  • Perform a standardized equipment check to ensure availability and function of supplies and equipment
  • Ask the 3 rapid evaluation questions to confirm the expected gestational age, note muscle tone, and assess initial respiratory effort and determine whether the newborn can stay with the mother or should move to the radiant warmer
  • Demonstrate the sequence of steps to follow during resuscitation
  • Begin positive-pressure ventilation (PPV) with room air (21% oxygen) for infants greater than or equal to 35 weeks’ gestation
  • Evaluate respirations, heart rate, and oxygen saturation at appropriate intervals; consider using a cardiac monitor if positive-pressure ventilation is needed
  • Interpret the target oxygen saturation table to guide oxygen administration
  • Demonstrate effective and supportive communication with parent(s) regarding the plan of care
  • Apply the NRP Key Behavioral Skills to improve teamwork and communication
  • Demonstrate components of antenatal counseling that promote a trusting relationship and shared decision-making with the parent(s)
  • Demonstrate technical and behavioral skills necessary to perform complex resuscitation 
  • Use a cardiac monitor for accurate assessment of heart rate if pulse oximetry is not functioning, if the baby’s heart rate is low, or if the baby has poor perfusion
  • Summarize the ethical principles associated with starting and stopping neonatal resuscitation
  • Demonstrate how to communicate with parents and involve them in ethical decision making whenever possible
  • Describe how long to continue resuscitation attempts when the baby does not respond
  • Demonstrate what to do when a baby dies
  • Summarize how to help parents and team members through the grieving process

Product Details

Product Number SMS7538 (Version 4)
Author Name American Academy of Pediatrics
Simulator Tools Simulator-Based Training
Supported Devices LLEAP, SimPad
Simulator Mode Instructor Mode
Summative/Formative Formative
Scenario Can Be Modified Yes
Estimated Time to Run Scenario 20 minute(s)
Language English
Laerdal Equipment Patient Monitor, SpO2 Probe

Patient and Setting Details

Patient Age 0 Hour(s)
Patient Weight 3.5 kg(s)
Patient Gender Female
Setting Delivery room

Additional Information

Description

This scenario, which is part of the Neonatal Resuscitation Scenarios for SimNewB, is designed to teach neonatal resuscitation based on principles from the Textbook of Neonatal Resuscitation, 7th edition and in accordance with the 2015 AAP/AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of the Neonate.

This case presents a term newborn whose mother has not felt fetal movement for several days. At birth, the baby is limp and apneic with no detectable heart rate. The newborn does not respond to complex resuscitation including administration of medication through an emergency umbilical catheter, and the scenario ends in the death of the newborn. The scenario focuses on when it is reasonable to consider discontinuing resuscitative efforts, and strategies to support the family and resuscitation team members.

The scenario provides learners with an opportunity to use and integrate cognitive, technical, and behavioral skills, practice newborn assessment and management, use critical thinking skills, and build teamwork and communication. As a help for the instructor, the scenario includes a list of reflective questions and a section with clinical points to consider during simulation and debriefing. Based on the interventions that are logged by the instructor during simulation, the pre-programmed scenario file will generate an annotated log file, which may also be helpful for instructors during the debriefing session.

The pre-programmed scenario file is compatible with SimPad, SimPad PLUS and LLEAP Automatic Mode and is made for use with the SimNewB simulator. The scenario can also be used with SimPad Manual Mode, but more functionality will be available when using Automatic Mode.

Related Products

Multiple License Discount

License Discount
1st License List Price
2nd License 50% off
3rd + License 90% off

A discount is available when multiple licenses of the same product are purchased.

Licensing Information

Capital License:A Capital License is typically purchased from the customer’s capital budget. It gives a customer the right to use a scenario product for an unlimited period of time and for an unlimited number of times. If an update is made to the product, customers with a Capital License will receive the update if it falls within one year from the purchase date. After that timeframe, the customer will keep the existing version of the product without future updates. In addition, Customer Service will support a Capital License for a period of one year from the purchase date.

Annual License: An Annual License is typically purchased from the customer’s operating budget. It gives a customer the right to use a scenario product for a Period of one year from the purchase date, for an unlimited number of times. If an update is made to the product, customers with a valid Annual License will receive the update. Customer Service will support an Annual License as long as it is active.At the end of the Annual License period, customers will receive a message from SimStore,alerting them to their expiring license and providing instruction on how to extend the license.

Please Note: Some products may only be available with a Capital or Annual License, not both.

Licensing Information

Capital License: A Capital License is typically purchased from the customer’s capital budget. It gives a customer the right to use a scenario product for an unlimited period of time and for an unlimited number of times. If an update is made to the product, customers with a Capital License will receive the update if it falls within one year from the purchase date. After that timeframe, the customer will keep the existing version of the product without future updates. In addition, Customer Service will support a Capital License for a period of one year from the purchase date.

Annual License: An Annual License is typically purchased from the customer’s operating budget. It gives a customer the right to use a scenario product for a Period of one year from the purchase date, for an unlimited number of times. If an update is made to the product, customers with a valid Annual License will receive the update. Customer Service will support an Annual License as long as it is active.At the end of the Annual License period, customers will receive a message from SimStore,alerting them to their expiring license and providing instruction on how to extend the license.

Please Note: Some products may only be available with a Capital or Annual License, not both.

Free Trial License - Terms of Use

The free Trial License enables you to evaluate whether a scenario meets your organization's needs. Please carefully review the Terms of Use before accessing your free trial.

  • Customers receive full access to the scenario during the trial period. This means that you can view the scenario file in your Scenario File Editor, run the scenario using your Instructor App or SimPad(which may or may not be connected to a simulator), and view the scenario Support Materials.
  • Three Free Trial Licenses are available per institution for each scenario product.
  • The free Trial License expires in 72 hours.
  • If a new version of a scenario product is created, a free Trial License will be made available for the new version.

Free Trial License - Terms of Use

The free Trial License enables you to evaluate whether a scenario meets your organization's needs. Please carefully review the Terms of Use before accessing your free trial.

  • Customers receive full access to the scenario during the trial period. This means that you can view the scenario file in your Scenario File Editor, run the scenario using your Instructor App or SimPad(which may or may not be connected to a simulator), and view the scenario Support Materials.
  • Three Free Trial Licenses are available per institution for each scenario product.
  • The free Trial License expires in 72 hours.
  • If a new version of a scenario product is created, a free Trial License will be made available for the new version.

Volume Discounts - Terms of Use

  • A Volume Discount is available when a customer purchases multiple licenses of the same product, within the same transaction. Example: Quantity= 3 for the Mild Asthma scenario.
  • A Volume Discount is not applicable when a customer purchases a single license of multiple different products.
  • It is recommended that customers purchase a scenario license for each applicable simulator they own. For example, if you purchase a SimBaby scenario and you own 2 SimBaby simulators, we recommend that you purchase a quantity of 2 licenses for that scenario.
  • Promotional discounts may be available occasionally. These discounts would be added to your volume discount.