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The Silent Saboteur: Teaching the Clinical Implications of Occult Hypoxemia & Social Determinants of Health via a Pulmonary Embolism Case
DOI: https://doi.org/10.21980/J8FD14By the end of this oral board case, learners will be able to: 1) obtain appropriate history of present illness (HPI) and physical exam elements for the undifferentiated chest pain patient, 2) identify elements of history and physical exam that are compatible with pulmonary embolism, 3) formulate a differential diagnosis for chest pain and perform the appropriate work-up to narrow this differential diagnosis, 4) appropriately manage pulmonary embolism, 5) review and discuss the diversity, equity and inclusion (DEI) elements of the case, and 6) review and discuss the importance of social determinants of health (SDH) in disposition decisions and patient outcomes.
Diabetic Ketoacidosis and Necrotizing Soft Tissue Infection
DOI: https://doi.org/10.21980/J89M0KAt the end of this oral board session, examinees will: 1) Demonstrate the ability to obtain a complete medical history and physical exam. 2) Identify and appropriately treat DKA. 3) Identify, treat, and make appropriate consults for NSTI. 4) Demonstrate effective communication of the treatment plan with the patient.
My Broken Heart
DOI: https://doi.org/10.21980/J85W7RBy the end of this simulation session, learners will be able to: 1) assess the hemodynamics of an LVAD patient by using a Doppler to determine mean arterial pressure, 2) Manage an arrhythmia in an LVAD patient with a suction event by addressing preload, 3) Identify and treat the source of hypovolemia (a massive lower gastrointestinal hemorrhage), 4) Perform clear closed-loop communication with other team members.
Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation
DOI: https://doi.org/10.21980/J82354ABSTRACT: Audience: This simulation is designed for critical care transport providers but can be easily adapted for the inpatient setting. It is applicable to an interdisciplinary team including nurses, respiratory therapists, medical students, emergency medicine residents, and emergency medicine attendings. Introduction: Cardiogenic shock carries an incredibly high burden of morbidity and mortality. Acute myocardial infarction accounts for 81% of cardiogenic
Innovative Ultrasound-Guided Erector Spinae Plane Nerve Block Model for Training Emergency Medicine Physicians
DOI: https://doi.org/10.21980/J8PW7DThis innovation model is designed to facilitate hands-on training of the ultrasound-guided ESP nerve block using a practical, realistic, and cost-effective ballistics gel model. By the end of this training session, learners should be able to: 1) identify relevant sonoanatomy on the created simulation model; 2) demonstrate proper in-plane technique; and 3) successfully replicate the procedure on a different target on the created training model.
Orthopaedic Surgery Didactic Session Improves Confidence in Distal Radius Fracture Management by Emergency Medicine Residents
DOI: https://doi.org/10.21980/J8K365By the end of this didactic session, learners should be able to: 1) assess DRF displacement on pre-reduction radiography and formulate reduction strategies, 2) perform a closed reduction of a DRF, 3) apply a safe and appropriate plaster splint to patient with a DRF and assess the patient’s neurovascular status, 4) assess DRF post-reduction radiography for relative fracture alignment, and 5) understand appropriate follow-up and necessary return precautions.
A Case Report of an Unstable C-spine Fracture in the Emergency Department
DOI: https://doi.org/10.21980/J8SK90The initial workup in the ED showed an acute displaced fracture of the left occipital condyle (CT-coronal, fracture of the left occipital condyle, red arrow; displacement, orange line), a shattered left lateral mass with involvement of the vertebral canal (CT-axial, red arrow), and malalignment of the craniocervical junction (CT-sagittal, red outline). The CT angiogram head and neck showed a possible irregularity in the left vertebral artery. The CT head without contrast had no significant findings.
Eye-Opener: A Case Report of Eyelid Taping as Presenting Symptom of Myasthenia Gravis
DOI: https://doi.org/10.21980/J8NW8GPhysical exam was significant for a very pleasant, well-appearing female in no acute distress, noted to have clear plastic tape attached to her bilateral eyelids and brows (Image 1). When the tape was removed, she had bilateral ptosis, more significantly in the left eye (Image 2). She had no conjunctival injection or pallor. Her airway was patent and protected. She had no neck masses or carotid bruits. Her heart and lung exams were normal, with no evident respiratory distress. Her neurologic exam was further significant for limited extra-ocular movement (EOM). Her most notable deficits were with lateral and upward gaze (Video 1) indicative of weakness at the muscles innervated by cranial nerves III and VI. Her pupillary response was symmetric and brisk bilaterally. She had no additional cranial nerve deficits, slurred speech, or asymmetry in her strength or sensation throughout.
A Case Report of Inferior Rectus Abscess
DOI: https://doi.org/10.21980/J8J35GNon-contrast computed tomography (CT) imaging of the head in coronal, sagittal, and axial planes revealed a distinct 1.7 x 2.2 x 1.4 cm peripherally enhancing fluid collection within the left inferior orbit, involving the inferior rectus (yellow circle). This lesion resulted in restricted extraocular motility due to structural compression of the left globe. Laboratory results showed a mildly elevated white blood cell count of 11.5/mm3 and otherwise normal results including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
A Case Report of Hydropic Gallbladder Presenting as Right Lower Quadrant Abdominal Pain
DOI: https://doi.org/10.21980/J8DD26Computed tomography (CT) of the abdomen and pelvis with contrast was ordered, and general surgery was consulted for the initial working diagnosis of acute appendicitis. However, the CT scan resulted with findings of a markedly distended gallbladder measuring approximately 14.5 x 4 centimeters (cm) with marked gallbladder wall thickening (magenta) and pericholecystic fat stranding (cyan). The appendix was not dilated and had no inflammatory changes or edema. Follow-up right upper quadrant ultrasound confirmed the diagnosis of acute cholecystitis.