Posts by JETem

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FAST Exam to Diagnose Subcapsular Renal Hematoma

Michelle Sofia Bakardjiev, MD* and Amanda Esposito, MD^

DOI: https://doi.org/10.21980/J8NP8DIssue 4:4 [mrp_rating_result]
A bedside point of care ultrasound FAST exam was performed revealing a left subcapsular renal hematoma. The hematoma was a non-compressing hematoma, evidenced by preserved renal contour with the hematoma labeled with a red H and the normal renal contour labeled with a green K. Additionally, cortical necrosis and ischemia can be characterized by a dark, hypoechogenic renal cortex on ultrasonography with a decrease in flow to the cortex on color doppler which was not seen on this patient, providing further evidence that the hematoma was non-compressing. The hematoma was concluded to be an acute process due to its hypoechoic appearance with some mixed ultrasonographic echoes caused by the early deposit of fibrin.
Renal/ElectrolytesVisual EM
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Right Upper Quadrant Pain in a World Explorer

Julia Hutchison, DO* and Nur-Ain Nadir, MD, MHPE*

DOI: https://doi.org/10.21980/J8QP9D Issue 4:4 [mrp_rating_result]
The ultrasound images show the abscess, which is a large, circular, hypoechoic mass outlined in blue in the center of the image. The abscess is surrounded by the hyperechoic and heterogeneous liver tissue. For better delineation of the abscess, a CT was ordered. The axial CT scan image shows the liver abscess, which appears as a hypodense, ovoid, intrahepatic fluid collection within the liver parenchyma. The size of the abscess has been annotated with a dotted line measuring 194.9 mm x 166.2 mm.
Abdominal/GastroenterologyVisual EM

Tricyclic Antidepressant Overdose

Patrick G Meloy, MD*, Amit Bhambri, MD^ and Megan C Henn, MD*

DOI: https://doi.org/10.21980/J85W50Issue 4:3 [mrp_rating_result]
At the end of this oral boards session, learners will be able to: 1) discuss the appropriate laboratory testing and workup for a patient with undifferentiated altered mental status, 2) discuss the importance of obtaining an ECG in a timely manner in order to investigate the broad differential of altered mental status, 3) identify the classic ECG findings of a patient with TCA overdose, 4) review the treatment of TCA overdose, 5) discuss the appropriate disposition of a patient with TCA overdose.
ToxicologyCertifying Exam Cases

Thyroid Storm

Natalie Ferretti, MD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J8XD03Issue 4:3[mrp_rating_result]
By the end of this simulation session, the learner will be able to: 1) understand the essential physical exam components necessary to evaluate for etiologies of acute encephalopathy, 2) review laboratory and imaging studies to obtain for evaluation of acute encephalopathy and/or suspected thyroid storm, as well as the rationale behind ordering each study, 3) identify underlying etiologies or pathologies for developing thyroid storm, 4) discuss treatment for thyroid storm.
EndocrineSimulation

A Simulated Scenario to Improve Communication Skills of Residents Providing Online Medical Command of Emergency Medical Service Providers

Anthony Steratore, MD*, Erica B Shaver, MD*, Melinda J Sharon, MPH*, Adam Hoffman, MCCP^, Peter S Martin, MD* and Christopher S Kiefer, MD*

DOI: https://doi.org/10.21980/J8SK8MIssue 4:3[mrp_rating_result]
By the end of this simulation, learners will be able to: 1) discuss appropriate medical command instructions for pediatric cardiac arrest; 2) describe alternative methods to obtain weight-based dosing of pediatric critical care medications, if Broselow tape is unavailable; 3) identify need for a definitive airway in a pulseless patient without interruption of chest compressions. Identify need for rapid intraosseous access in a pulseless pediatric patient; 4) describe the indications for helicopter transfer in a critically ill child.
EMSSimulation

Post-Termination Hemorrhage

Nichole Niknafs, DO* and Alisa Wray, MD^

DOI: https://doi.org/10.21980/J8NW6Q Issue 4:3[mrp_rating_result]
By the end of this simulation, participants will be able to: 1) recognize post-termination hemorrhage and hemorrhagic shock; 2) demonstrate appropriate acute resuscitation for a patient with hemorrhagic shock; 3) review the differential diagnosis for a patient with post-termination hemorrhage; 4) identify the indications for massive transfusion protocol.
Ob/GynSimulation

Thyroid Storm in the Emergency Department

Christopher Eric McCoy, MD, MPH* and Reid Honda, MD*

DOI: https://doi.org/10.21980/J8234RIssue 4:3[mrp_rating_result]
By the end of this simulation-based session, the learner will be able to: 1) Recognize the signs and symptoms of thyroid storm and appropriately diagnose a patient with thyroid storm. 2) Choose appropriate medications for the treatment of thyroid storm. 3) Determine the appropriate disposition for a patient presenting in thyroid storm. 4) Discuss the rationale behind each drug used to treat thyroid storm. 5) List at least three precipitants of thyroid storm.
EndocrineSimulation

A Story About Mesenteric Ischemia

Annahieta Kalantari, DO*

DOI: https://doi.org/10.21980/J8J33Q Issue 4:3[mrp_rating_result]
We aim to teach the presentation and management of cardiovascular emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.
Abdominal/GastroenterologyCardiology/VascularSmall Group Learning