Posts by JETem

Pulmonary Arteriovenous Malformation in a Patient with Suspected Hereditary Hemorrhagic Telangiectasia: A Case Report

Nadia Zuabi, MD^*, Sean Ryan Thompson, BS^*, Alexa Lucas, BS^*, Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8M353 Issue 6:1 No ratings yet.

Initial vital signs were unremarkable, including oxygen saturation of 98% on room air. The patient did not exhibit any signs of respiratory distress, and the lungs were clear to auscultation bilaterally. Labs were obtained, which showed normal hemoglobin at 15.8. Computed tomography (CT) of the chest (Video 1) showed a large left upper lobe arteriovenous malformation (AVM) with large feeding arteries and tortuous dilated draining veins (red arrow) measuring up to 3.8cm. Imaging also demonstrated nonspecific multifocal ground-glass opacities, which may have represented pulmonary hemorrhage (blue outline) from AVM without evidence of contrast extravasation to suggest active bleeding.

Visual EM Respiratory

Case Report: Not Your Typical Kidney Stone

Laura Kolster, DO* and Danielle Biggs, MD*

DOI: https://doi.org/10.21980/J8GD2T Issue 6:1 No ratings yet.

The CT scan demonstrates nephrolithiasis with associated forniceal rupture. Encircled in the yellow outline is fluid, demonstrating a forniceal rupture. The stone is in the proximal aspect of the ureter, as highlighted by the purple arrow.

Renal/Electrolytes Visual EM

A Case Report of a Transected Carotid Artery Caused by a Stab Wound to the Neck

Jennifer Roh, MD^*and Kylie Prentice, BS^*

DOI: https://doi.org/10.21980/J8BP8M Issue 6:1 No ratings yet.

The post intubation chest x-ray (CXR) showed severe rightward displacement of the trachea (purple arrow). The computed tomography angiogram (CTA) showed transection of the left common carotid artery (LCCA), extensive neck hematoma without extravasation and severe tracheal deviation to the right (blue arrow). The intravenous (IV) contrasted chest computed tomography (CT) image showed a lateral contrast projection from the aortic arch at the level of the isthmus (green and pink arrows). There were no other significant injuries reported on the CT scans of the chest, abdomen and pelvis.

Cardiology/Vascular Trauma Visual EM

Case Report of COVID-19 Positive Male with Late-Onset Full Body Maculopapular Rash

Sarah Harirforoosh, MD^*, Jessica Hoffmann, MD^{^}and Emily Bernal^†

DOI: https://doi.org/10.21980/J86W72 Issue 6:1 No ratings yet.

The images demonstrate a diffuse, flat, maculopapular exanthema along the torso, bilateral upper and lower extremities, and neck without edema consistent with reported cutaneous manifestations of COVID-19. There are no surrounding bullae, vesicles, or draining. On palpation, there was blanching of the rash. Sensation to light touch was intact in all extremities. The findings were also apparent on the face with no mucosal involvement.

Dermatology Infectious Disease Visual EM

Posterior Sternoclavicular Dislocation: A Case Report

Stephanie Songey, DO^*, Christopher Goodwill, DO^* and Kimberly Sokol, MD, MS, MACM^*

DOI: https://doi.org/10.21980/J8363Q Issue 6:1 No ratings yet.

Chest X-ray revealed an inferiorly displaced right clavicle at the right sternoclavicular joint (blue arrow). A computed tomography angiogram (CTA) of the chest was therefore obtained and revealed a right posterior sternoclavicular dislocation with resultant compression of the left brachiocephalic vein (purple arrow). Even though the right clavicle is displaced, the anatomy of the brachiocephalic vein is such that it is positioned to the right of midline, placing the left brachiocephalic vein posterior to the right clavicle. The right brachiocephalic and common carotid artery were normal in appearance. The CTA also revealed a comminuted fracture of the left anterior second rib at the costochondral junction that had not been previously seen on the x-ray.

Orthopedics Trauma Visual EM

Case Report: Traumatic Tension Pneumothorax in a Pediatric Patient

Zachary Tritsch, MD^*, Gayle Galan, MD^*, Gary Oates, MD^*and Janelle Thomas, MD^*

DOI: https://doi.org/10.21980/J8ZD1S Issue 6:1 No ratings yet.

Chest X-ray demonstrated significant right-sided pneumothorax (with red outline showing border of collapsed right lung) with cardio mediastinal shift to the left (shown by blue arrows) indicative of a tension pneumothorax

Trauma Pediatrics Respiratory Visual EM

Vomiting in Pediatric Patients

Alisa Wray, MD, MAEd^*, Daryn Towle, MD^*, Alexa Lucas, BS^*, Sean Thompson, BS^*, Katie Rebillot, DO^{^} and Nichole Niknafs, DO^†

DOI: https://doi.org/10.21980/J8P363Issue 5:4 No ratings yet.

By the end of this TBL session, learners should be able to: 1) Identify red flag symptoms that should prompt referral for urgent intervention by GI or surgical specialists; 2) recognize how chronicity of the vomiting can alter the differential diagnosis; 3) describe the varying pathways that can cause nausea and vomiting; 4) determine the necessity of imaging tests to confirm and possibly treat various causes of vomiting; 5) interpret imaging studies associated with specific causes of vomiting.

Abdominal/Gastroenterology Pediatrics Team Based Learning (TBL)

Febrile Seizure Team-based Learning

Mary Jane Piroutek, MD^*

DOI: https://doi.org/10.21980/J8JD12 Issue 5:4 No ratings yet.

By the end of this educational session, the learner will: 1) list the characteristics of a simple febrile seizure; 2) discuss the management of a child with a simple vs. complex febrile seizure; 3) discuss the risk factors that correlate with an increased risk of a subsequent febrile seizure; 4) determine when a lumbar puncture should be considered in a febrile child with a seizure; 5) identify when to give anti-epileptics and construct an algorithm for their use; 6) discuss with parents, provide education and return precautions.

Neurology Team Based Learning (TBL)

What do you do if your relief comes to work intoxicated: An Impaired Provider Scenario

David A Gay, MD^*, Anthony F Steratore, MD^*, Adam Hoffman, CHSE^{^}, Jessica M Neidhardt, MD^*, Courtney A Cundiff, MD^*, Erica B Shaver, MD^*, Autumn Starn Kiefer MD^† and Christopher Stephen Kiefer, MD^*

DOI: https://doi.org/10.21980/J8DM0H Issue 5:4 No ratings yet.

By the end of this simulation, learners will be able to: 1) Identify potential impairment in the form of alcohol intoxication in a physician colleague; 2) demonstrate the ability to communicate effectively with the colleague and remove them from the patient care environment; 3) discuss the appropriate next steps in identifying long-term wellness resources for the impaired colleague; and 4) demonstrate understanding of the need to continue to provide care for the patients by moving the case forward.

Administration Simulation

Extracorporeal Membrane Oxygenation (ECMO) for Refractory Cardiac Arrest

Kevin Hanneken, MD^*, David Gaieski, MD,^*Amrita Vempati, MD^*and Ronald Hall, MD^*

DOI: https://doi.org/10.21980/J88W69 Issue 5:4 No ratings yet.

ABSTRACT: Audience: Our target audience includes emergency medicine residents/physicians. Introduction: Treating cardiac arrest is a common theme during simulated emergency medicine training; however, less time is focused on treating refractory cases of cardiac arrest. There are varying definitions of refractory cardiac arrest, but it is most commonly defined as the inability to obtain return of spontaneous circulation (ROSC) after 10-30

Cardiology/Vascular Simulation