This simulation-based educational activity presents a pediatric emergency department scenario involving a critically injured child who ultimately dies from suspected non-accidental trauma (child abuse). The case is designed to expose learners to the rare but high-stakes situation of pediatric death during resuscitation. Participants practice identifying and managing life-threatening traumatic injuries while applying Advanced Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS) principles. The activity also emphasizes team organization, crisis communication, and the psychosocial aspects of caring for families during pediatric resuscitation and death. Learners must recognize signs of child abuse, initiate appropriate medical interventions (e.g., tube thoracostomy, transfusion protocols), and manage both clinical and emotional challenges, including determining when resuscitative efforts are futile and communicating with distressed family members.
Target Learners
This activity is designed for interdisciplinary healthcare learners involved in emergency or acute care settings, including:
- Third- and fourth-year medical students
- Emergency medicine residents
- Emergency medicine faculty
- Emergency department nurses
- Other emergency department clinical staff
The case can be adapted for different training levels by emphasizing either medical management (for junior learners) or complex decision-making and family communication (for advanced learners).
Equipment Needed
Typical equipment for a high-fidelity emergency medicine simulation is required, including:
Simulation and Monitoring
- High-fidelity pediatric simulation mannequin
- Cardiac monitor/defibrillator
- Pulse oximeter
- Blood pressure monitor
Airway and Resuscitation Equipment
- Bag-valve mask
- Oxygen supply
- Airway equipment (laryngoscope, endotracheal tubes, suction)
Procedural Supplies
- Intravenous access supplies
- Chest tube and thoracostomy tray
- Pelvic binder or sheet for pelvic stabilization
- Massive transfusion protocol materials or simulated blood products
Diagnostic Materials
- Chest X-ray image demonstrating hemothorax
- Pelvic X-ray image demonstrating pelvic fracture
- Ultrasound or simulated E-FAST findings
Additional Materials
- C-collar and spinal immobilization equipment
- Case prompts or scenario scripts
- Family member role players (optional but recommended)
Estimated Time to Complete the Activity
Typical simulation session timing:
- Pre-briefing: 10–15 minutes
- Simulation scenario: 15–20 minutes
- Debriefing and discussion: 30–45 minutes
Total estimated time: approximately 60–80 minutes.