Posts by JETem
Trapped In Transit – A Case Report of a Pediatric Gastric Bezoar Causing Intermittent Small Bowel Obstruction
DOI: https://doi.org/10.5070/M5.52259The CT scan identified a heterogenous, mass-like lesion extending from the gastric fundus to the antrum, along with a small bowel obstruction (SBO) and significant small bowel dilation. An additional smaller heterogenous mass-like lesion was seen in the small bowel, causing the SBO. Given the mass-like lesion’s mixed attenuation and presence of internal air, a gastric bezoar was strongly suspected.
Overlooked and Undernourished: A Case Report of Scurvy Linked to Food Insecurity
DOI: https://doi.org/10.5070/M5.52313Images A and B of the lower extremities show what initially appeared to be a petechial rash with scattered ecchymoses bilaterally, primarily on the right lower leg. On closer examination, images C and D more clearly show these spots to be flat and non-blanching, indicative of follicular hyperkeratosis with perifollicular hemorrhages. The classic coiled or corkscrew hair findings are not seen in these images. Image E shows evidence of palatal ecchymosis, without evidence of gingival bleeding, likely due to loss of dentition. This constellation of exam findings reflects the production of weakened or dysfunctional collagen in connective tissue and vascular structures and is strongly suggestive of the clinical diagnosis of scurvy. Image F shows resolution of the patient’s dermatologic findings after three weeks of treatment.
Enhancing Emergency Medicine Resident Education: A Weekly Education Series to Augment Electrocardiogram Education
DOI: https://doi.org/10.5070/M5.52141The goals of the curriculum were to establish an asynchronous ECG curriculum to help improve standardization of EM resident education, expose EM residents to a more comprehensive ECG curriculum, increase active learning in this arena, and decrease the administrative burden while not dedicating further conference time towards ECG education.
Development and Design of a Pediatric Case-Based Virtual Escape Room on Acute Iron Toxicity
DOI: https://doi.org/10.5070/M5.52192By the end of the activity, learners should be able to: 1)recognize the history and clinical presentation of acute iron toxicity; 2) demonstrate knowledge of the necessary workup in suspected iron toxicity; 3) identify the stages of acute iron toxicity; 4) identify management of iron toxicity and its complications; 5) perform appropriate management in the setting of decompensated hemorrhagic shock and hypovolemia; and 6) demonstrate teamwork through communication and collaboration.
Pre-Clinical Case Competition to Assess Confidence in Responding to Select Out-Of-Hospital Medical Emergencies
DOI: https://doi.org/10.5070/M5.52198By the end of this activity, learners will be able to: 1) demonstrate the application of skills in real-life first responder scenarios, including suspected opioid overdose, cardiac arrest, and anaphylaxis; 2) apply knowledge of scene safety and the role of the first responder in various situations; and 3) assess the challenges while applying the skills necessary for collaborative work within a medical team.
Pediatric Difficult Airway Simulation Day
DOI: https://doi.org/10.5070/M5.52208The objective of this one-day simulation workshop is to increase learner confidence and skills necessary to perform critical pediatric airway procedures. PEM fellows of all training levels at our institution completed a three-hour “PEM Difficult Airway Day,” which consisted of six 30-minute stations focusing on airway scenarios critical for PEM fellow training: five high- and low-fidelity simulations (premature neonate, inhalational injury, contaminated airway, obese patient, and failed airway) and one discussion-based station on the physiologically difficult intubation. By the end of this workshop, learners will be able to: 1) identify various clinical situations in which a pediatric patient may have a difficult airway, 2) successfully intubate mannequins with simulated difficult airways using direct laryngoscopy (DL), video laryngoscopy (VL), laryngeal mask airway (LMA) placement, bougie-assisted intubation, and a hyper-angulated VL blade, and 3) recognize and describe the management of physiologically difficult airways and failed airways.
Cards Against Pulmonology
DOI: https://doi.org/10.5070/M5.52358By the end of this card game, learners will 1) understand the methods of clinical assessment in thoracic-respiratory related diseases, 2) implement escalating levels of respiratory support for thoracic-respiratory pathology in pediatric and adult patients, 3) review and utilize important medications in the management of thoracic-respiratory diseases, and 4) choose appropriate dispositions of patients with various thoracic-respiratory related complaints.
Clinical Decision-Making Case: Febrile Infant
DOI: https://doi.org/10.5070/M5.52290By the end of this CDM case, learners will be able to: 1) demonstrate familiarity with the CDM case format, 2) recognize the critical importance of fever in a neonate and initiate a thorough evaluation, 3) develop an appropriate differential diagnosis and understand the workup for febrile neonates, 4) identify and justify the appropriate diagnostic studies and interpret their findings in the context of a neonate with fever, 5) justify a treatment plan and understand the critical disposition of a neonate with fever.