HHS

Harry is a 65 year old male brought to the ER by ambulance after being found confused and lethargic at home by his daughter. Has been urinating frequently and very thirsty for the past four days. Reports blurry vision, weakness, and a dull headache but no nausea or vomiting. He says he hasn't been eating much and missed his diabetes medication because he was feeling "off."

Inpatient Hospital Room - ICU

1. By the end of the simulation, the student will accurately assess a patient with Hyperglycemic Hyperosmolar Syndrome (HHS) by identifying at least four key clinical indicators
2. During the simulation, the student will initiate and manage fluid replacement therapy based on clinical guidelines, selecting the appropriate type and rate of IV fluids (e.g., 0.9% Normal Saline) to restore perfusion while preventing fluid overload, with a goal of achieving improved hemodynamic stability within 30 minutes of intervention.
3. Within the simulation, the student will safely administer prescribed insulin therapy (e.g., IV regular insulin infusion) while following institutional protocols for titration and ensuring that glucose levels decrease gradually by 50-70 mg/dL per hour to prevent cerebral edema.
4. Before the end of the scenario, the student will provide an SBAR handoff report to the next provider, including critical updates on fluid status, glucose trends, mental status, and electrolyte imbalances. Additionally, the student will educate the patient (or family) on at least three key prevention strategies to reduce the risk of future HHS episodes (e.g., blood sugar monitoring, hydration, recognizing early symptoms).

1. Recognize and differentiate HHS from diabetic ketoacidosis (DKA) using clinical assessment and lab interpretation.
2. Correctly administer IV fluids, insulin therapy, and electrolyte replacement while monitoring for adverse effects.
3. Accurately document vital signs, interventions, and patient response in the electronic health record (EHR).
4. Educate the patient and/or caregiver on early signs of dehydration and hyperglycemia to prevent readmission.