Pediatric Emergency Medicine Simulation Curriculum: Hyponatremic Seizures

This simulation-based educational activity is designed to train healthcare providers in the recognition and management of status epilepticus caused by hyponatremia in a pediatric patient. Learners participate in the care of a 4-month-old infant presenting with ongoing seizure activity in the emergency department resuscitation setting. The scenario requires participants to perform rapid primary assessment, stabilize airway, breathing, and circulation, obtain intravenous access, initiate appropriate anti-epileptic therapy, and identify electrolyte abnormalities as the underlying etiology of seizure activity.

The case emphasizes both technical and non-technical skills including diagnostic reasoning, medication management, teamwork, and communication during pediatric emergencies. Simulation is followed by a structured debriefing session focused on medical management, emotional processing, and interprofessional collaboration to reinforce learning objectives and improve patient safety practices.

Target Learners 

This activity is appropriate for: 

• Pediatric residents 

• Emergency medicine residents 

• Pediatric emergency medicine fellows 

• Emergency department nurses 

• Pediatric or emergency medicine faculty 

• Interprofessional emergency response teams involved in pediatric resuscitation 

No prerequisite preparation is required for participation. 

Equipment Needed 

Simulation Environment 

• Emergency department resuscitation room or simulation laboratory 

• High-fidelity infant mannequin 

• Hospital bed and patient identification band 

Monitoring Equipment 

• Cardiac monitor 

• Pulse oximeter 

• Non-invasive blood pressure monitor 

• Respiratory rate monitor 

• Temperature probe 

Resuscitation Supplies 

• IV access supplies 

• Airway management equipment 

• Personal protective equipment (gloves, gowns, masks, face shields) 

• Documentation forms 

• Pediatric weight estimation tool 

• Broselow tape or pediatric medication reference cards 

• PALS reference materials 

Medications 

• Benzodiazepines (e.g., lorazepam, midazolam) 

• Second-line anti-epileptics (e.g., fosphenytoin, levetiracetam, phenobarbital) 

• Hypertonic saline (3%) for hyponatremia 

• IV fluids (normal saline, lactated Ringer’s) 

• RSI medications as appropriate (e.g., atropine, etomidate, ketamine, rocuronium) 

• Antibiotics and antipyretics (optional depending on scenario variation) 

Estimated Time to Complete the Activity