SIM Scenario Exchange

Anaphylaxis – Adult

Contributed on June 30, 2016, last updated June 28, 2022.



Michelle Connell, RN,BSN, Vancouver Coastal Health – Lion’s Gate Hospital Emergency Dept

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Mike is a 35 year old male. He was on a first date at Nami sushi on Lonsdale. His date offered him gomae, he took one bite and felt lip tingling immediately, he told his date about his severe peanut allergy and they came to the ED. No Epi Pen.
Triage nurse to present case to Emerg Nurse. Additional info: Pt is now drooling with a hoarse voice and notable lip swelling.
Pt’s status deteriorates (over approximately 5 minutes)
Pt continues to decline, unable to verbalise, airway occluded, resp distress
Pt improves with cricothyrotomy

Learning Objectives:

Learning Objectives:
By the end of the debriefing the participants should be able to:

Knowledge & Skills:

Identify anaphylaxis shock
Manage difficult airway
Treat anaphylaxis (including giving epi IM and epi infusion)
Demonstrate placement of cricothyrotomy

Attitudes and Judgement:
Demonstrate role clarity, delegation of roles and responsibilities at the initiation of the scenario
Demonstrate effective communication during the scenario: constructing clear messages, closed loop

communication, sharing mental model

Demonstrate effective resource utilization
Exhibit situational awareness / global awareness: recognizing limitations, avoiding fixation error


Simulation Modality:



High sophistication adult manikin


Used twice in emergency departement.  Adapted based on feedback.


Connell M. Anaphylaxis – Adult. Simulation resource published by Simulation Canada; 2016. Available from

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Target Learners




Respiratory Therapy
Social Work


Continuing professional development
Graduate / postgraduate / residency

Fields / Disciplines:

Emergency / trauma

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