Myasthenic crisis escalation
Educational use only. Not clinically reviewed45-year-old woman for calm impending-crisis recognition, qualified airway ownership, later crisis review, and active-risk handoff. About 7 simulated minutes.
What you will practise
- Reconcile the rapid clock, fatigable weakness, bulbar and respiratory trajectory, supplied measurements, physiology, and whole-patient state.
- Recognize impending myasthenic crisis without reassurance from oxygen saturation, carbon dioxide, or one respiratory-mechanics cutoff.
- Activate qualified neurology, neurocritical, respiratory, nursing, and airway-capable ownership.
- Review secretion and aspiration safety, infection, medication exposures, testing limits, and alternative causes in parallel.
- At a strict later report, review worsening bulbar and ventilatory function with the supplied qualified-airway trajectory.
- After another elapsed interval, hand off crisis status, trigger, treatment, airway, weaning, recurrence, and active risk.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology. 2016;87:419-425. doi:10.1212/WNL.0000000000002790.
- Claytor B, Cho SM, Li Y. Myasthenic crisis. Muscle Nerve. 2023;68:8-19. doi:10.1002/mus.27832.
- McKenzie ED, Kromm JA, Mobach T, et al. Risk Stratification and Management of Acute Respiratory Failure in Patients With Neuromuscular Disease. Crit Care Med. 2024;52:1781-1789. doi:10.1097/CCM.0000000000006417.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.