A 16:9 widescreen thumbnail image divided into visual sections under a dark blue header. Header Title: Bold white text reading "PEDIATRIC SIMULATION SCENARIO:" followed by a large, bright yellow title reading "BEE STING ANAPHYLAXIS". Left Graphic: An illustration of a crying 8-month-old infant in a blue onesie sitting down, showing facial flushing, a swollen upper lip, and a bee sting mark on the inner thigh. Center Graphic: A warning triangle containing a bee icon, placed above an emergency epinephrine auto-injector with an arrow pointing toward the simulation setup. Right Graphic: A pediatric high-fidelity simulator mannequin ("SimBaby") resting on a medical gurney connected to ECG monitors, next to a clinical checklist covering key steps: "Recognize Stridor & Swelling," "Administer Epinephrine," and "Manage Airway." Branding: "TheSimTech" logo and branding in the bottom-right corner.

Bee Sting Anaphylaxis in an 8-Month Old – Pediatric Simulation Scenario

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theSimTech Editorial
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This blog post highlights a pediatric emergency simulation scenario focused on anaphylaxis triggered by a bee sting in an 8‑month‑old infant. In this scenario, learners respond to a recent field sting, identify evolving airway and hemodynamic compromise, and implement pediatric emergency protocols under realistic team dynamics.

Case Narrative: Scenario Content Scenario Background Mother and baby were out in the field behind their house. While mom was in back doing gardening baby was on blanket playing and was stung by a bee. Mom did not initially see sting, baby started crying and she found a sting on babies’ inner thigh. Mom tried to breast feed initially not realizing baby was stung but noticed his lip swelling. Brought him to ER once he started “making a weird sound when he was crying.” Family/social hx: Father is allergic to bees and nuts. Pmhx: none / no meds
A warm, sunny garden scene in front of a residential house: Foreground: A smiling 8-month-old infant in a light blue onesie sitting on a colorful patchwork blanket in the grass, holding a wooden toy. Bee Detail: Just to the right of the blanket, a detailed bee rests on a bright yellow flower amidst daisies and red poppies. Background: The baby's mother is tending to a raised garden bed with a hose, with her back turned to the child. A cozy single-story home sits softly out of focus in the sunny background.

The scenario and its resources are available from the download page at https://thesimtech.org/scenarios.

Table of contents

Why this topic matters in healthcare education and medical simulation

Anaphylaxis is a time-critical condition where rapid recognition and coordinated treatment can dramatically impact outcomes. Pediatric patients present unique challenges in airway management, pharmacologic dosing, and escalation of care. Using simulated pediatric anaphylaxis with a bee sting trigger helps learners practice:

  • Early recognition of signs such as lip/tongue swelling, stridor, and other respiratory symptoms in infants
  • Appropriate medication selection and dosing for pediatric anaphylaxis, including adrenergic support and adjuncts
  • Leadership, communication, and coordination during a pediatric code scenario
  • Decision-making under pressure and the mechanics of rapid sequence interventions when indicated

What the scenario enables learners and educators to do

  • Engage in a structured, hands-on approach to a suspected pediatric anaphylactic reaction in the ED setting
  • Practice assessment, airway management readiness, and procedural interventions appropriate for a pediatric patient
  • Collaborate with care team members (nurses, physicians, and support staff) to delegate roles and communicate clearly during a time-critical event
  • Apply debriefing to reflect on clinical actions, teamwork, and opportunities for improvement
Simulation Setup Sheet (SimBaby) Patient Setup – SimBaby Gender: 8-month-old male Moulage: IV 22G covered until requested by residents; red swollen lip (illustrated on an outline diagram of an infant wearing a diaper, with IV site marked on the right upper arm). Monitors/Equipment: Diaper clean, nasal cannula available on room air, normal pupils. Patient Position: Stretcher/Gurney (Back) Vascular Access Setup IV: 22–24G placed in R arm at start (covered). IV Fluids: Normal Saline available. IO Supplies / Infusion Pump: Available in crash cart (regular & EZIO); pump available. Equipment & Crash Cart Airway Equipment: Nasal cannula, Endotracheal tubes (sizes 3.0, 3.5, 4.0), Peds NRB mask, Peds Stylette, Laryngoscope handle & blades (MAC 1, 2; Miller 1, 2), LMA, Nebulizer, Oxygen, Peds BVM with mask. Head of Bed: CO₂ monitor leads, EKG leads, Nasal cannula, Peds BVM, Peds NRB mask, Stethoscope, Suction machine with tubing & canister. Actors & Roles ER Nurse: Inexperienced and anxious; calls code overhead or into doctor lounge. Junior ER Doctor: Inexperienced and anxious; performing chest compressions. Sim Computer & Control Room Instructions for starting the simulation, opening "Anesthesia Peds" / "PALS VF", setting up camera views, and verifying audio/video feeds.

Additional educator resources included in the package and how they support deployment and facilitation

The scenario package includes educator resources designed to support facilitators before, during, and after the simulation. These resources help standardize delivery, guide scoring, and structure reflective learning:

Clinical Flowchart & Vitals Key Legend Pink: Must select from event menu to make action occur. Blue: Will progress automatically based on time or action. Patient Case Summary Presentation: 8-month-old male in ER with lip and facial swelling, uvula and tongue swelling, crying with noticeable stridor on inspiration. PMH/Meds: Healthy / None. Family/Social Hx: Father is allergic to bee stings and nuts. Clinical Decision Path Initial State (Vitals): HR: 132 (sinus) | RR: 28 | BP: 122/76 | SpO₂: 92% RA | Temp: 37°C Branch A: Epi Given & O₂ Applied (Expected Management) Timeline: 2–3 minutes Outcome (Improvement): HR 126 | RR 24 | BP 110/72 | SpO₂ 100% on O₂ | Temp 37.0°C | Eyes opened. Branch B: Epi Not Given Outcome (Decline): HR 140 | RR 18 → 12 → 8 | BP 90/70 → 65/45 | SpO₂ 85% on O₂ | Temp 37.0°C | Eyes closed. Next Expected Steps: Epi drip, discuss intubation, discuss surgical airway.
  • facilitator guides: Provide step-by-step facilitation instructions, timing cues, and prompts to keep the scenario on track while allowing learners to demonstrate decision-making and team dynamics.
  • checklists and assessment tools: Offer objective ways to document learner performance, including recognition of anaphylaxis, appropriate medication dosing, and leadership during resuscitation.
  • debriefing aids: Present focused prompts and a guided debrief framework to help instructors elicit reflection on clinical actions, communication, and non-technical skills.
  • scenario materials and logs: Include logistics and setup checklists, equipment lists, and role descriptions to ensure a faithful and repeatable setup.

Each resource plays a specific role in ensuring the scenario can be deployed consistently across sessions and settings, supports learner reflection, and facilitates targeted feedback and remediation where needed.

Availability

The scenario and its resources are available from the download page at https://thesimtech.org/scenarios.