This educational resource provides the information and materials for a high-fidelity simulation case suitable for medical students and resident physicians in emergency medicine. The case involves a young woman who presents with syncope and abdominal pain. A pregnancy test in the emergency department is positive, which is a concerning finding for this patient, who has had a tubal ligation. She is hypotensive and tachycardic, with a bedside ultrasound significant for intra-abdominal free fluid and a possible left-sided ectopic pregnancy. Appropriate treatment includes fluid resuscitation, obstetrical consultation, blood transfusion if necessary, and disposition to the operating room for a presumed ruptured ectopic pregnancy. Debriefing materials are provided to illustrate and stimulate discussion of the important concepts for diagnosing and treating patients with ectopic pregnancy. The case is currently in use at our institution for upper-level emergency medicine residents completing required educational time in our Emergency Department Simulation Program. The case has been used for the past 3 years in our program and has recently been edited and expanded to its existing form. This scenario has been presented for small groups of three to four participants and has been field-tested approximately six times in the last 3 years. All participants have been PGY1, PGY2, and PGY3 emergency medicine residents.
By the end of this simulation, learners will be able to:
- Demonstrate an appropriate initial approach to a patient with hypotension and tachycardia.
- Identify features concerning for a possible ectopic pregnancy.
- Demonstrate appropriate management of ruptured ectopic pregnancy.
- List the risk factors for ectopic pregnancy.
- Understand benefits and limitations of ultrasound in the diagnosis of an ectopic pregnancy.
- Describe nonsurgical management options for ectopic pregnancy.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivatives license.