EMERGENCY ROOM. Essential Question: Where Do We Start? Learning Targets: Lesson Overview

Transcription

1 EMERGENCY ROOM Essential Question: Where Do We Start? Learning Targets: Students will: Use a variety of media to develop and deepen understanding of a topic or idea. Effectively engage in collaborative discussions with peers. Explore the regions of the brain responsible for common functions. Connect parts of the brain to its functions. Lesson Overview This lesson begins with the skateboard accident patient regaining consciousness in the hospital. The health science careers that are introduced in this lesson focus on the ER and range from registration to the emergency doctor and radiologist. Young Professionals are introduced to details about the brain and brain injuries. 1

2 Lesson Agenda Opening (5 min) Emergency Scenario: Emergency Room Work Time Brain, It s a Dangerous World (15 min) Brain Stations (15 min) The Healing Brain (15 min) CT Scans (10 min) Closure (5 min) Metacognitive Three Materials CT Scan videos (to project) Young Allied Health Professional student packet Brain Hemisphere Hat Materials for the Oatmeal Brain 2 eggs in plastic containers Brain Stations materials: Skittles Phineas Gage video (to project) The Healing Brain station materials: Bucket of rice Pair of rubber gloves Small items to hide in the bucket of rice (i.e. paperclip, screw, elastic, quarter, key, etc.) Comprehension passage with answer key <Find the Spy!> descriptors and answer key Melon Head Experiment materials (extension) FACILITATION NOTES The Narrative Arc. The more each <Emergency Scenario> can be presented as if telling a story, the more engaged the audience will be. Work to avoid a stale reading and lean towards bringing the information to life as in a conversation or a reveal of the next chapter. Think of creative ways to make the story your own. Brain Hemisphere Hat. The Brain Hemisphere Hat is a 2

3 physical model that shows students the brain has many different regions that are responsible for different functions. This is purely introductory and is meant to provide a different representation that contrasts the brain scan images. Pass the Brain. Prepare a physical model of the brain using the Kitchen Brain Model (Adapted from Brainlink): o 2 cups water o 2 cups flour o 4 teaspoons cream of tartar o One quarter cup vegetable oil o 1 cup salt Mix the water, salt, flour, and cream of tartar in a large bowl or blender until the lumps disappear. Then mix in the vegetable oil. Put the entire mixture into a saucepan and "cook" it over low heat until it gets lumpy. Pour the mixture out and let it cool. Then knead and shape it into the form of a brain. Brain Stations. These activities have been adapted from a Skills for Success: Growth Mindset lesson on the Tour of the Brain, which provides more in-depth information on the lobes of the brain and their functions. For the purposes of this lesson, they are meant to provide more activity-based work that introduces students to the idea that different areas of the brain have different functions, and injuring these areas can affect their functions. The Healing Brain. These quick station activities highlight what can happen (i.e. sensory loss) when patients experience a brain injury. Be sure to debrief each activity, asking students to empathize with the experiences patients with brain injuries have and highlighting what recovery can look and feel like for these patients. EXTENSIONS Melon Head Experiment. If seeking to make this more of an activity-based lesson, consider incorporating the Melon Head Experiment. See p. 13 of the following document for lesson instructions: % pdf. During the debrief, be sure to compare and contrast what happens during a brain injury versus what happens to the melon (i.e. one comparison is that although there may not be visible damage on the outside of the melon after a drop, the fluid and melon on the inside may have been moved around or damaged, much like what can occur in a brain injury even if you do not see damage on the head or skull). 3

4 IN ADVANCE Be prepared to project the videos: o What is a CT Scan? (1:17). Note: This video is dated and uses the term CAT Scan, which is interchangeable with CT Scan. Most updated sources use the term CT Scan. Be sure to remain consistent with the terminology you use in this lesson. o Having a CT Scan of Your Head, found at This video shows a child having a CT Scan and the radiologist s role in collecting and viewing the images (3:35). Vocabulary Content triage, CT Scan, induced, cerebrospinal fluid, temporal lobe, frontal lobe, sensory loss inference Tier II Opening (5 min) Emergency Scenario A lot has to happen in a short amount of time to determine the injury a person has and begin treatment. And time is of the essence minutes matter in the survival and recovery of the patient. What are some of the different tasks health professionals must complete in the emergency room? 1. Invite the young professionals to pair-share with a colleague. 2. Use equity sticks to select several responses. 3. Listen for: Take your temperature and heart rate (check your vital signs), gather personal information about you (name, birthday, allergies, etc.), reassure you, analyze injuries (perform x-rays, CT Scans, etc.), and provide treatment (stitches, casts). 4. Distribute the <Emergency Scenario: Emergency Room> to the young professionals. 5. Invite them to follow along as you perform the script aloud. 4

5 Work Time Brain, It s a Dangerous World (15 min) The brain is an amazing thing, but it is extremely fragile. It is made up of a number of different lobes that serve different functions. If you experience a traumatic brain injury, the area of the brain that is affected may not be able to perform its function properly. Let s take a closer look at some of the regions of the brain. 1. Don the <Brain Hemisphere Hat>: 2. Pass the model around and give students an opportunity to explore the different regions labeled. Our brain is mostly water and fat and has the consistency of tofu. It is only 2% of our body weight, but uses 20% of our energy. 3. Pass the Oatmeal Brain from group to group now. o Remind YPs to take a few moments to feel the brain model as it comes around. o They should be careful not to rip the bag as they feel the brain they can squish the model, but it should not be punctured, thrown or pummeled! The brain s squishy consistency makes it fragile and prone to injuries. Who knows what protects this valuable organ? Listen for: The skull, cerebrospinal fluid, cranium. Most likely, students will only identify the skull which is perfect for this demonstration. Our brain is inside of our skull. Is there anything else to help protect it? Protecting the Brain Demonstration 1. Share: This egg represents the brain. This plastic container represents the skull. If the skull is the only thing protecting our brain, what will happen? 2. Place egg in container and cap. 3. Select a YP to shake the container. Wow, what a mess! What else could we add to the container to ensure our delicate brain remains undamaged? Listen for: Padding, fluid. 5

6 In our brain, we have another layer of protection, the cerebrospinal fluid. Will this be enough to help protect our brain from impact? 5. Add a new egg to a container. Fill with water. Cap. 6. Select a YP volunteer to shake the container. From this model, we see an example of how the skull and the cerebrospinal fluid work together to protect the brain. However, an intense impact to the head can still result in brain damage, especially if the skull is not protected by a helmet. Unfortunately, our patient was not wearing a helmet. Let s see what happens when we injure our brain. Let s take a closer look at some of the brain s lobes and their functions and explore how these functions can be interrupted due to brain injuries. Brain Stations (15 min) The Temporal Lobe This part of our brain has many smaller structures that perform the functions of recognizing faces or objects, comprehending language, short-term memory, smell, hearing, and taste. In this activity we are going to see how smell and taste work together. In your nose are small hairs and cells that take in stimuli. These messages travel to your brain where they are received in the temporal lobe. In a moment, I will hand out a candy to each of you. Do not eat it. Do not look at its color. 1. Have students shut their eyes. 2. Distribute a Skittle to each student. 3. Instruct students to completely plug their noses and keep them plugged. 4. Invite students to eat the skittle once the skittle is in their mouth they can open their eyes, but must keep plugging their noses. Ask: What do you notice about your sense of taste? Can you guess the flavor/color of your candy? Say: The temporal lobe brings your senses of smell and taste together to help you create an idea of what flavors you are eating. As you noticed when your sense of smell was blocked, your sense of taste was not as strong. What do you think can happen to a patient whose temporal lobe was injured? 6

7 Listen for: Weaker sense of smell, taste, and hearing, inability to recognize faces or comprehend languages, lack of short-term memory. The Frontal Lobe Our frontal lobe controls our highest cognitive functions including language, emotions, rational thought, self-control, and decision making. What happens if this part of the brain is damaged? The odd case of Phineas Gage helps to illustrate the importance of this part of our brain. 1. Show the following BrainCraft clip to 2:30, The Man with a Hole in His Brain: 2. Have students think-pair-share their reactions. Use equity sticks to have some share their reactions with the class. The Healing Brain (15 min) Now that we have explored some of the specific regions of the brain and what can happen if these regions are injured, let s dig deeper into what a brain injury can feel like and how the brain recovers. What Can It Possibly Be? Patients with a brain injury may experience a number of different symptoms. We explored some specific symptoms that might occur to a patient with an injury to the temporal or frontal lobes of the brain. Depending on the severity of the injury and its location, patients will have different experiences during recovery. 1. Direct students attention to the bucket of rice. Explain that a series of small objects have been hidden inside the bucket. 2. Use equity sticks to select 3-4 volunteers to find an object. Ensure they put on a pair of rubber gloves before beginning their search. 3. After each item has been found, ask: How did it feel when you were trying to find the hidden objects? Was it easy? 4. Listen for: The gloves and rice made it difficult to feel the hidden objects, making it harder to locate smaller items. 5. Provide students who were not selected to find an object an opportunity to feel inside the bucket while wearing rubber gloves. 6. Ask: How does this relate to a symptom a patient with a brain injury might experience? 7

8 7. Listen for: A patient with a brain injury can experience sensory loss, making it difficult to feel and locate objects, especially if they are small. 8. Explain that a recovering patient might experience different degrees of sensory loss (i.e. a patient on the way to recovery might have a similar experience to feeling the objects in rice without the added barrier of rubber gloves). Find the Spy! Your brain works hard to make sense of the information it s given. When it s injured, the speed at which the brain can take in and process information might be affected. Let s take a few minutes to explore information processing in the brain. 1. Direct students to the <Find the Spy!> handout in their young professional student packets. 2. Explain that you will be reading a description of a spy and that the YPs must determine which spy on their handout matches the description. Tell the YPs to pay close attention as you read through each descriptor they will not be allowed to interrupt or ask questions once you begin reading. 3. Read through the description the first time at a quick pace. After providing brief think time for the YPs to process, read the description a final time at a moderate pace. 4. Ask: Who thinks they have the correct spy? 5. Use equity sticks to solicit guesses. Listen for: Sigmund the Spy! 6. Debrief: How did it feel to process information after the first time I read through the description? What strategies did you use to help you select the correct spy? Listen for: It was frustrating and difficult to process the information when you read through it quickly. Strategies will vary. Be sure to highlight if not brought up by the YPs: Active listening, note-taking, process of elimination. 7. Check for understanding: How does this relate to brain injuries? How does it relate to recovery? 8. Use equity sticks to solicit responses. Listen for: Patients with an injured brain can experience as much difficulty processing information given at a normal speed as we did when it was read quickly. Recovering patients might experience less difficulty, like when the information was read again at a moderate speed. Take this opportunity to highlight study skills the YPs can employ to help them select the correct spy: active listening, notetaking, and process of elimination. Ask: How can study skills be affected by brain injuries? What s the Thing? Our last activity involves the brain s ability to understand and clarify information that initially may seem confusing. As I read the following passage, think about how the comprehension task relates to brain injuries and recovery. 8

9 1. Explain that you will be reading a passage about a common thing. The YPs must guess what the thing is after you finish reading. 2. When you finish the passage, provide think time for the YPs to pair share their ideas. 3. Use equity sticks to solicit guesses. Read the passage a second time if no correct guesses are given. 4. Once the YPs guess correctly, re-read the passage. Ask: Now that you know what the thing is, does the passage make more sense? 5. Debrief: How does this relate to brain injuries? How does it relate to recovery? 6. Listen for: A brain injury can make it difficult to understand common daily processes (like laundry). Recovery can be similar to the Aha! moment we experienced when hearing the passage after realizing it was laundry. CT Scans (10 min) An emergency patient has been referred to radiology for diagnosis of a traumatic brain injury. Your job, as a young radiology technician, is to administer and evaluate the scan of the brain and determine the type and extent of the brain injury. The patient suffered a traumatic brain injury when he crashed while skateboarding and scored a 9 on the Glasgow Coma Scale. He had lost consciousness for more than a few minutes and was not responsive verbally or with eye movement for that time. He has since gained consciousness but is disoriented and does not remember the accident. You decide to run a Computed Tomography (CT) Scan to assess his injuries. 1. Ask: Does anyone know what a CT Scan is? o Project <What Is a CT Scan> video: 2. Project the <Having a CT Scan of Your Head> video: o o Invite the young professionals to make observations or ask questions about CT Scans. Inquire if anyone has had a CT Scan. The brain can suffer many injuries and illnesses that all have their unique marks on a CT Scan. First, let s study a CT Scan image of a healthy brain. This brief activity has some challenging vocabulary words. Contextualize vocabulary by defining them as you go: a hematoma, a bruise, is often a sign of injury. Remember that concepts are more important than memorizing the words. 1. Project the <Healthy Brain> image. 9

10 2. Ask: What do you notice about this brain? 3. Invite students to pair-share their observations. 4. Point out what to expect in a healthy brain scan: o o In a healthy brain scan, there is no hematoma found. A hematoma is a bruise (even when you have a bruise showing on your skin, it is called a hematoma). A hematoma will often show up on an injured brain scan as a dark grey spot. A healthy brain scan also shows four, butterfly-shaped ventricles. These are fluid-filled cavities that are supposed to be centered around the midline, or the middle of the brain. In an injured brain, the ventricles may be off-center, changing their butterfly formation. In the next lesson, you will be radiologists matching the picture of a brain injury or disease with its description. You will need to use your problem solving skills to make inferences on what type of injury is being displayed so you can provide the best treatment for your patient! Closure (5 min) Metacognitive Three Today, we started to learn about the lobes of the brain and their different functions. We now know that if specific regions of the brain are injured, those regions may not be able to properly carry out their functions. In our healthy brains, our frontal lobe is responsible for a high-level thought process known as metacognition, or the awareness and understanding of our own learning. Let s take a moment to engage our metacognitive abilities. 1. Invite students to turn to a blank page in their notebooks. 2. Ask: How will you remember the information you learned today for the next lesson? 3. Encourage students to take three minutes to jot down specific study strategies that will help them review what they learned today. 4. Tell students that they will need to use these strategies to prepare for solving brain injury mysteries in the next lesson, and they should spend some time studying today s material at home. This closure activity provides young people with the opportunity to reflect on their own learning habits. Guide them through this process by ensuring they are suggesting specific study strategies that will help them remember the information best. Implement the Xtreme Study Skills Skills for Success lesson to highlight researchedbased effective study skills (and identify those that didn t make the cut like highlighting and reviewing my notes ). 10

11 Name: Date: EMERGENCY ROOM: Where Do We Start? Today s Learning Objectives: I can: Use a variety of media to develop and deepen my understanding of a topic or idea. Effectively engage in collaborative discussions with my peers. Explore the regions of the brain responsible for common functions. Connect parts of the brain to its functions. This lesson begins with the skateboard accident patient regaining consciousness in the hospital. The health science careers that are introduced in this lesson focus on the ER and range from registration to the emergency doctor and radiologist. I will be introduced to details about the brain and brain injuries. Today s Activities: Emergency Scenario: Emergency Room Brain, It s a Dangerous World Brain Stations CT Scans Metacognitive Three 11

12 Emergency Scenario: The Emergency Room You have regained consciousness in a helicopter! What happened? You hurt all over and are wrapped up like a burrito in what feels like shrink-wrap. The helicopter lands and you are rushed into the emergency room. The people helping you keep saying that you re doing fine and everything is OK, but you don t feel OK and no one has told you what happened. All you can remember is that you were skateboarding on your way to the community center. When you arrive at the hospital, you are immediately wheeled in on a rolling bed to a treatment room, and a nurse begins to take your temperature and heart rate. You later learn that she is called a triage nurse. It is her job to prioritize treatment of people in the emergency room. Usually, the worst cases get treated first. You guess you must be pretty badly hurt. Your parents arrive in your room with another person who works at the hospital. This person talks to your parents about you your name, birthday, and allergies, all the things that doctors ask you. They also get your parents to sign a form that says you can be treated by the hospital. Your mom tells you that this person does the intake registration. He also puts a hospital bracelet on your wrist and places stickers on all the papers and file folders. He says that he has to do this so that you don t get confused with someone else and get the wrong treatment. The next person to enter the room is the emergency doctor herself. She puts her hand on your shoulder and tells you that you re going to be fine. She then explains that you have a very bad laceration, or cut, on your face. You are going to need stitches and will have a scar. She also says that your left arm is broken and you will need to have an X-ray so they can fix the bones correctly. She then asks you what you remember about the accident. You tell her that you remember skateboarding to day camp and then waking up in a helicopter. She says that you have a contusion, a brain injury from bruising caused by leaking blood vessels, and need to have something called a CT Scan, where a special X-ray is used to see inside your brain. The doctor explains that you will be at the hospital for a while and need to stay a couple of days, because they re worried about your brain swelling. If your brain swells, it may not get enough oxygen, because the blood can t flow easily through the blood vessels. If there is a lack of oxygen, you could have brain damage or die! 12

13 Find the Spy! 13

14 Facilitator Documents: Healthy Brain Image to Project 14

15 Find the Spy! Descriptors and Answer Key 1. Read the following clues very fast to the class: Sly Sam Sneakpeep always wears a hat. Sam is standing with his hands in his pockets. He does not wear glasses. Sly Sam is carrying something under his left arm. Sam has a long nose. He is wearing dark-colored shoes. The collar of Sam s coat is turned up around his neck 2. Ask the class Which of these men is really Sam? Read the clues again at a slower pace. (Answer: Sigmund is really Sam) 15

16 Comprehension Passage & Answer Key Read the following Comprehension Passage to the class: Doing this is really easy. First, put the things in different piles or just one if there are not too many things. Doing a few things at a time is better than many things. This activity can get tricky. Mistakes can happen and cost money. But after a while you get used to doing this. And that s good because this activity never ends. After you do this activity you put the things in groups again. Then you can put the groups away. Later the things will be used again. And then you start all over again. That s life! Answer: Laundry 16

17 Extension: Melon Head Experiment 17