This high-fidelity simulation activity is designed to teach learners the recognition and management of septic shock complicated by disseminated intravascular coagulation (DIC). The case presents a patient with pneumococcal septicemia who develops coagulopathy, requiring participants to apply principles of early goal-directed therapy in accordance with current sepsis management guidelines. Learners must simultaneously identify systemic inflammatory response syndrome (SIRS), severe sepsis, metabolic derangements, and evolving hematologic abnormalities while initiating appropriate resuscitative measures, diagnostic testing, and antimicrobial therapy. The scenario also promotes development of a differential diagnosis for thrombocytopenia, with emphasis on distinguishing DIC from thrombotic thrombocytopenic purpura (TTP) and immune thrombocytopenic purpura (ITP). A structured debriefing session and post-simulation self-assessment reinforce clinical reasoning and evidence-based management of septic shock with associated coagulopathies.
Target Learners
- Emergency Medicine Residents (PGY 1–3)
- Fourth-Year Medical Students
- Other senior medical trainees participating in acute care or emergency medicine simulation curricula
Equipment Needed
- Simulation laboratory
- High-fidelity patient simulator/mannequin
- Cardiac monitor
- Supplemental oxygen delivery equipment
- Two large-bore intravenous (IV) access supplies
- Standard laboratory testing capability (simulated)
- IV fluid resuscitation supplies
- Simulated broad-spectrum antibiotic medications
- Finger-stick glucose testing equipment
Estimated Time to Complete Activity
- Simulation scenario: 30–45 minutes
- Post-simulation debriefing: 30–60 minutes
- Self-assessment/homework assignment: Completed independently following the session
Total Estimated Time: 60–105 minutes (excluding independent post-session work)