ICU Patient — Insulin Drip Running, Glucose 48, Patient on Propofol Sedation

About This Case

This clinical reasoning case presents a patient with icu patient / insulin drip running / glucose 48 / patient on propofol sedation in a endocrinology context. Learners work through a structured 10-phase simulation covering initial differential, history-taking, physical examination, labs and imaging, and management planning.

"Your patient on an insulin drip has a glucose of 48. She is sedated and cannot report symptoms. The insulin drip order says 'hold for glucose <70 and call MD.' You hold the drip and give dextrose. Thirty minutes later glucose is 62. The intern says 'glucose is coming up, resume the drip at the previous rate.' What do you say?"

How the Simulation Works

1. Read the patient presentation and form your initial differential diagnosis
2. Interview the AI patient to gather history and explore your hypotheses
3. Perform a focused physical examination based on your differential
4. Order appropriate labs and imaging, then interpret the results
5. Revise your diagnosis and develop a management plan
6. Receive personalized teaching feedback from your AI attending, Dr. Patel

What You'll Learn

This case builds skills in systematic clinical reasoning, hypothesis-driven history-taking, appropriate test ordering, and evidence-based management. It is designed for Nursing students and practicing clinicians seeking to sharpen diagnostic thinking in endocrinology.

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About ReasonDx

ReasonDx is an AI-powered clinical reasoning education platform developed by Dr. Lauren Fine, MD, FAAAAI, Associate Professor and Assistant Dean of Clinical Skills Education at NSU Dr. Kiran C. Patel College of Allopathic Medicine. The platform features 394 simulation cases across 10 health professions, designed to train the cognitive processes underlying accurate diagnosis.