On-site interprofessional education (IPE) simulation is primarily used to teach students teamwork, communication, and crisis resource management. Participants view it as an educational environment in which to acquire and consolidate skills. Virtual IPE simulation is traditionally seen as an opportunity to supplement, complement, and reinforce on-site IPE (OI). We used VI as the sole simulation method during the COVID-19 pandemic to provide IPE because of constraints of social distancing. The VI resulted in substantially achieving similar learning outcomes to OI. This suggests that VI, which has the advantage of being cheaper and more easily scalable than OI, may be an effective remote learning modality for IPE. Supplemental digital content is available in the text.

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INTRODUCTION:Pulmonary Embolism (PE) affects 0.5%-1 per 1000 people in the general population and the commonest cause of death among hospital inpatients. Intraoperative PE are relatively uncommon, but may occur with specific surgeries such as long bone fractures and tumor surgeries. Clinical presentation is usually sudden with cardiovascular collapse and death. In acute massive PE, 50% of the patient will die within 15 minutes and only 33 % will survive over 2 hours. CASE PRESENTATION:A 44-year-old Male patient presented with a right ankle fracture. He was scheduled for open reduction and internal fixation. Past medical history was negative. He smoked, drank alcohol and used cocaine. He is 110 kg, height of 190 cm. Patient underwent general anesthesia for the surgery. He was placed on mechanical ventilation to maintain end tidal carbon dioxide tension (ETCO2) between 30 to 35 mmHg. Vital signs remained stable until 60 minutes after induction, following positioning in the left lateral decubitus postion, it was noted that the ETCO2 was 17 mmHg. Pulse oximeter saturation (SPO2) ranging from 95 to 100%. Vital signs remained stable. An immediate search for the cause was undertaken. Auscultation of the chest showed vesicular breath sounds. The breathing circuit did not reveal any leaks or disconnects. Bronchoscopy also showed the endotracheal tube to be in proper position. A possible diagnosis of pulmonary embolism was made and an ABG was sent for analysis. ABG showed respiratory acidosis with a pH of 7.21, pCO2 of 76, with an ETCO2 of 17. The surgeon was notified and surgery was expedited. Patient was kept intubated. Spiral chest CT which showed a pulmonary embolus involving the right main pulmonary artery.The patient was transferred to the ICU where he was started on enoxaparin 1 mg per kg q 12 hours. He also had an IVC filter placed. He made a slow but gradually recovery and was discharged home 2 weeks later.