Objective Structured Clinical Examination Skill Station Is Effective for Assessing Acute Opioid Overdose Resuscitation

Authors: Matthew P. Abrams , Martin Klapheke

Date Published: Nov 23,2020

Introduction
This presentation has three parts:
1. The paper which presents the project (Opiod OSCE).
2. The same paper's appendix A includes a guide upon how they built this OSCE, information which may prove helpful to aspiring CSI module writers.
3. Here are 8 photos of the OSCE skill station: Opiod OSCE photos.
Please note there are NO VIDEOS for this project.

Educational Objectives
Use of this simulation OSCE initiated with graduating fourth-year medical students, but its use could be expanded as detailed by the authors. The desired learning outcome is to increase the learner’s experience and confidence in recognizing and managing a patient needing opioid overdose resuscitation outside the hospital setting as outlined in a mnemonic of opioid overdose resuscitation, “ACNS”:
-Assess and Activate Emergency Medical Services
-Cardiopulmonary Resuscitation
-Naloxone administration
-Stay and continue to assess until Emergency Medical Services arrive

Description
By the end of this session, learners will be able to:
1. Perform an assessment of a nonresponsive patient with a suspected opioid-related emergency outside the 2020 Abrams et al. Cureus 12(11): e11511. DOI 10.7759/cureus.11511 4 of 8 hospital setting.
2. Identify the opioid emergency and activate Emergency Medical Services.
3. Institute the steps of opioid overdose resuscitation including naloxone administration.
4. Continue to assess the patient-and if necessary administer additional naloxone-until Emergency Medical Services arrive.

Overview
The learner has just completed his/her fourth year of medical school and is flying home for vacation. Midway in the flight, the pilot asks if there is a health care professional on board, and no one else speaks up. The learner identifies himself/herself to the flight attendant as a graduated medical student. The flight attendant hurriedly takes the learner to the back of the plane where a woman is bending down in the aisle desperately trying to waken a man lying on the floor to the side of her. The flight attendant has left a ventilator bag-mask, as well as a plastic mask, in case they are needed. The woman says, “Please help me, I think my brother may have accidentally overdosed! I told him to stop taking so many hydrocodone!” The aim is to assess the learner’s clinical skill in recognizing a patient requiring emergent care and initiating evaluation and proper management of opioid overdose.