Simulation Library
Explore our full library of physician-authored emergency medicine simulations. Filter by category and difficulty. One scenario is always free.
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Intermediate · 25 min
A 58-year-old male presents with crushing chest pain radiating to the left arm. ECG shows ST elevation in leads II, III, and aVF. Navigate through critical decisions for acute myocardial infarction management.
Intermediate · 14 min
New atrial fibrillation with rapid rates and a borderline blood pressure. Decide who needs immediate cardioversion versus rate control, and manage the timing of anticoagulation.
Intermediate · 14 min
Flash pulmonary edema in a patient with known HFrEF. Start noninvasive ventilation and high-dose nitrates early, and distinguish SCAPE physiology from simple volume overload.
Advanced · 18 min
A witnessed arrest in coarse VF. Lead the resuscitation — high-quality CPR, defibrillation timing, drug sequencing — and manage the transition to post-arrest care.
Advanced · 14 min
Tearing chest pain radiating to the back in a hypertensive patient. Distinguish dissection from ACS, control heart rate before blood pressure, and mobilize surgery for a type A.
Advanced · 25 min
A 62-year-old man with ESRD on hemodialysis presents with generalized weakness after missing several dialysis sessions. Initial potassium is 7.4 mmol/L with peaked T waves and QRS widening on ECG. Navigate immediate cardiac stabilization, intracellular potassium shifting, rebound hyperkalemia, insulin-associated hypoglycemia, malignant dysrhythmia, and urgent hemodialysis activation.
Advanced · 30 min
A 72-year-old female with fever, altered mental status, and hypotension. Identify sepsis early and implement the Surviving Sepsis Campaign bundle within the golden hour.
Beginner · 20 min
A 2-year-old with first-time febrile seizure. Differentiate between simple and complex febrile seizures and manage appropriately while counseling anxious parents.
Advanced · 16 min
An 18-month-old with fever, lethargy, and thready pulses. Recognize compensated septic shock before the blood pressure falls, then execute weight-based fluids, early antibiotics, and vasoactive support.
Beginner · 12 min
A toddler with barking cough, stridor, and retractions overnight. Grade croup severity, use dexamethasone and nebulized epinephrine appropriately, and decide who is safe to go home.
Intermediate · 14 min
A dehydrated child with Kussmaul respirations and new-onset diabetes. Manage pediatric DKA — measured fluid strategy, insulin timing, potassium repletion — while staying alert for cerebral edema.
Advanced · 35 min
A 35-year-old involved in a motorcycle accident with loss of consciousness. Apply the Canadian CT Head Rule and manage increased intracranial pressure.
Advanced · 16 min
A positive FAST and deepening shock after a high-speed MVC. Run a disciplined primary survey, resuscitate with balanced blood products, and make the call for the operating room.
Advanced · 16 min · Free to play
A stab wound to the chest with tracheal deviation and collapse. Recognize tension pneumothorax clinically and decompress before imaging, then manage the chest tube and the injuries that remain.
Advanced · 14 min
An unstable pelvis with profound shock after a high-speed MVC. Apply a pelvic binder early, activate massive transfusion, and choose between angioembolization and the operating room.
Intermediate · 14 min
Neck pain and bilateral leg numbness after a high-speed MVC. Perform a structured neurologic assessment, distinguish neurogenic from hemorrhagic shock, and manage spinal precautions and disposition.
Advanced · 25 min
A 54-year-old man with known alcohol-related cirrhosis arrives by EMS actively vomiting large volumes of bright red blood, hypotensive and confused. In the resuscitation room, the fellow must control an airway threatened by ongoing hematemesis, activate massive transfusion with a restrictive hemoglobin target, and start octreotide and ceftriaxone early. Key decisions include sequencing intubation against volume resuscitation, deciding whether balloon tamponade is a bridge worth placing, and mobilizing emergent endoscopy versus interventional radiology. Over-transfusion and delayed airway control both carry consequences.
Intermediate · 25 min
A 28-year-old with severe asthma exacerbation not responding to initial bronchodilators. Escalate therapy appropriately and recognize impending respiratory failure.
Advanced · 14 min
Sudden dyspnea and shock after recent orthopedic surgery. Recognize massive PE, weigh systemic thrombolysis against its bleeding risk, and support a failing right ventricle.
Intermediate · 14 min
A hypercapnic COPD patient tiring on arrival. Titrate oxygen carefully, start noninvasive ventilation early, and recognize when NIV is failing and intubation cannot wait.
Beginner · 14 min
Sudden pleuritic chest pain in a tall young smoker. Confirm and size the pneumothorax, then choose among observation, aspiration, and chest tube — matching the intervention to the patient's stability.
Intermediate · 30 min
A 19-year-old presents 6 hours after intentional ingestion of 15g acetaminophen. Calculate the Rumack-Matthew nomogram and initiate N-acetylcysteine protocol.
Beginner · 12 min
An apneic, cyanotic patient with pinpoint pupils. Prioritize ventilation, titrate naloxone to respiratory drive rather than full arousal, and plan the observation period that prevents re-narcotization.
Advanced · 14 min
An unresponsive amitriptyline ingestion with seizures and anticholinergic signs. Recognize the sodium-channel toxidrome on ECG, treat with sodium bicarbonate, and manage the arrhythmias and hypotension that follow.
Advanced · 30 min
A 68-year-old with sudden onset right-sided weakness and aphasia. Work through the stroke code protocol and determine tPA eligibility within the critical time window.
Advanced · 16 min
Seven minutes of ongoing tonic-clonic seizure with hypoxia. Escalate benzodiazepines and second-line agents on schedule, protect the airway, and identify the precipitant.
Intermediate · 16 min
Fever, nuchal rigidity, and a petechial rash. Sequence antibiotics, steroids, CT, and lumbar puncture correctly — without letting the workup delay treatment.
Advanced · 30 min
A 32-week pregnant patient with severe headache and seizure. Recognize eclampsia, initiate magnesium sulfate, and coordinate with OB for emergent delivery.
Intermediate · 12 min
Sudden lower abdominal pain, shoulder pain, and hypotension in early pregnancy. Recognize a ruptured ectopic on bedside ultrasound, resuscitate, and mobilize OB/GYN for definitive operative management.
Advanced · 12 min
A boggy uterus and 1,500 mL of blood loss two hours after delivery. Work the postpartum hemorrhage algorithm — uterotonics, tranexamic acid, massive transfusion — while searching for the cause of ongoing bleeding.
Intermediate · 14 min
A peanut-allergic patient arrives hypotensive and hypoxic minutes after exposure. Recognize anaphylaxis early, give epinephrine without delay, and manage refractory shock and the threatened airway.
Intermediate · 18 min
An 82-year-old in respiratory distress has voiced — but never formalized — a wish to avoid intubation. Assess decision-making capacity in real time and align emergency airway decisions with the patient's goals of care.