8.5
Preconfigured Pediatric Scenarios
Tachycardia & Hypertension
Acute tachycardia develops when the instructor sequences to the Tachycardia &
Hypertension state. The peripheral pulse remains strong, and a blood pressure
determination indicates hypertension.
The facilitator should describe a “lite anesthesia” (i.e., concomitant increase in
surgical stimulation) situation to learners and use this scenario in conjunction with the
Tachycardia & Hypotension scenario to emphasize the importance of blood pressure
determination to diagnose the cause of intra-operative tachycardia. In this case,
appropriate treatment includes deepening the anesthetic with intravenous or inhaled
anesthetic agents and, depending on the patient history provided by the instructor,
administration of beta-adrenergic blocking medications (e.g., esmolol). Administering
vasoactive medications (for example, beta-adrenergic blockers) or additional
anesthetics correct the tachycardia and hypertension in a dose-dependent fashion.
Alternatively, the instructor may sequence to the “resolution” state, which automatically
causes the hemodynamics to return to normal (baseline).
Tachycardia & Hypertension
States, Events and Transitions
State 1
Baseline
Events None
Transitions None
State 2
Tachycardia & Hypertension
Events Heart rate factor: 2.00, Onset 0.50
Venous capacity factor: 1.00, Onset 0.50
Resistance factor: Systemic vasculature: 2.00, Onset 0.50
Transitions None
State 3
Resolution
Events Heart rate factor: 1.00, Onset 0.50
Venous capacity factor: 1.00, Onset 0.50
Resistance factor: Systemic vasculature: 1.00, Onset 0.50
Transitions None
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