Hybrid Simulations Using Standardized Patients and High Fidelity Mannequins for Anaphylaxis and Asthma Treatments in an Office Setting

This simulation-based educational activity is designed to improve the preparedness of healthcare teams in managing in-office medical emergencies, specifically anaphylaxis and acute asthma exacerbations. The curriculum utilizes a hybrid simulation model that integrates standardized patients (SPs) with high-fidelity mannequins to replicate realistic clinical scenarios in outpatient pediatric or family practice settings. Learners are organized using a structured team-training framework (Harvey team-training model), allowing participants to assume defined clinical roles and practice rapid assessment, communication, and intervention strategies during allergic emergencies. Real-time physiological responses from the mannequin enable learners to observe the clinical impact of their interventions. The activity includes case scripts, simulation flow diagrams, and objective evaluation tools such as the Clinical Emergency Preparedness Team Evaluation (CEPTE) to support performance assessment and structured debriefing.

Target Learners 

• Medical students 

• Nursing students and practicing nurses 

• Resident physicians 

• Practicing physicians 

Learners participate in small teams of approximately 4–6 participants, assuming roles such as: 

• Team leader 

• Airway manager 

• Medication nurse 

• Vital signs/CPR nurse 

• Scribe 

• Emergency caller (e.g., activates EMS) 

Equipment Needed 

Simulation Equipment 

• High-fidelity simulation mannequins (e.g., adult or pediatric SimMan, SimBaby) 

• Patient monitor displaying vital signs 

• Simulation software capable of real-time physiologic changes 

Clinical Props and Supplies 

• Epinephrine auto-injector (training device) 

• Intravenous (IV) tubing and needles 

• IV fluids 

• Oxygen supply with delivery tubing 

• Diphenhydramine solution (50 mg/mL) 

• Pediatric and adult endotracheal tubes 

• Laryngoscopes 

• Albuterol 0.083% inhalation solution 

• Nebulizer and nebulizer tubing 

Personnel 

• Standardized patients (actors) to portray: 

• • Patient 

• • Parent/spouse 

• • Nurse or support staff 

Estimated Time to Complete the Activity 

Multiple scenarios (e.g., peanut anaphylaxis, asthma exacerbation, GI anaphylaxis) may be conducted sequentially depending on curricular needs.