Cardiology/Vascular

My Broken Heart

Kelly N Roszczynialski, MD, MS^*, Alana E Harp, MD^{^}, Cameron A Fisk, MD^*,Kristen M Ng, MD, MEHP^† and Ashley C Rider, MD, MEHP^*

DOI: https://doi.org/10.21980/J85W7RIssue 10:2 No ratings yet.

By 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.

Current Issue Cardiology/Vascular Simulation

Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation

Matthew Heffernan, MD^{*^}, Jennifer Quinn, MSN^{*^}, Craig Tschautscher, MD^{*^}, Ryan Newberry, DO^{*^}, Andrew Cathers, MD^{*^} and Brittney Bernardoni, MD^{*^}

DOI: https://doi.org/10.21980/J82354 Issue 10:2 No ratings yet.

ABSTRACT: 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

Current Issue Cardiology/Vascular EMS Simulation

Journal Court: A Novel Approach to Incorporate Medicolegal Education into an Emergency Medicine Journal Club

Kevin McGurk, MD^*, Mary Jordan, MD^* and Bradley Davis, DO^*

DOI: https://doi.org/10.21980/J8093TIssue 10:1 No ratings yet.

By the end of this exercise, participants should: 1) identify the four necessary elements for a malpractice claim, 2) understand the basic structure of medical malpractice litigation, and 3) critically analyze medical literature representing diverging viewpoints or conclusions.

Cardiology/Vascular Miscellaneous (stats, etc)Small Group Learning

Drowning Complicated by Hypothermia

Alexander Close, MD^*and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8QS7P Issue 10:1 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) obtain a relevant focused history, including circumstances of drowning and/or cold exposure; 2) outline different clinical presentations of hypothermia, loosely correlated with core temperature readings; 3) discuss management of hypothermia, including passive external rewarming, active external rewarming, active internal rewarming, and extracorporeal blood rewarming; 4) discuss pathophysiology of drowning; 5) identify appropriate disposition of patients who present after drowning; and 6) identify appropriate disposition of hypothermic patients.

Cardiology/Vascular Simulation Wilderness

Wolff A et al. Right atrial thrombosis. Parasternal long US 3 annotated

A Case Report of Right Atrial Thrombosis Complicated by Multiple Pulmonary Emboli: POCUS For the Win!

Andrea Wolff, MD^*, Evan Leibner, MD^* and Jill Gualdoni, MD^{^}

DOI: https://doi.org/10.21980/J8TM07 Issue 10:1 No ratings yet.

Pulmonary POCUS was performed by the ED physician (GE Venue, C1-5-RS 5MHz curvilinear transducer), and lung examination was unremarkable with no pleural effusion, pneumothorax, or infiltrate. Subxiphoid views (GE Venue, 3Sc-RS 4MHz phased-array transducer) were obtained because this patient’s COPD with severe pulmonary hyperexpansion made parasternal and apical 4-chamber views suboptimal. A large thrombus can be seen within the right atrium (movie 1, images 1, 2). This has a serpiginous, rounded appearance and is mobile, appearing to swirl within the right atrium with intermittent extrusion through the tricuspid valve. A pacemaker wire is also visible within the right ventricle as a non-moving, hyperechoic, linear structure with posterior enhancement artifact. Pericardial effusion is not present.

Visual EM Cardiology/Vascular Ultrasound

Going in Blind: A Common Scenario in an Uncommon Situation

Ethan Hartman, MD^* and Kimberly Sokol, MD, MS, MACM^*

DOI: https://doi.org/10.21980/J8RS8C Issue 9:4 No ratings yet.

By the end of this simulation, learners will be able to (1) evaluate and treat a patient experiencing myocardial infarction and subsequent cardiac arrest during a power outage, (2) describe the local protocols for managing patient care during a power outage, (3) demonstrate the ability to coordinate a medical team during a simulated power outage in an emergency department with limited resources, (4) manage a cardiac arrest patient by following Advanced Cardiac Life Support (ACLS) protocols for bradycardia and ventricular fibrillation, and (5) justify the urgency of transfer to a certified ST segment elevation myocardial infarction center/cardiac intensive care unit, referencing the recommended 120-minute door-to-balloon time.

Cardiology/Vascular Miscellaneous (stats, etc)Simulation

A Realistic, Low-Cost Simulated Automated Chest Compression Device

Jessica Joyce, BS^*, Elyse Fults, MD^{^}, Julia Rajan, BS^†, Alexandra Plezia, MA^**, Carolyn Clayton, MD^{^} and Sara M Hock, MD^{^}

DOI: https://doi.org/10.21980/J8M63C Issue 9:2 No ratings yet.

By the end of this educational session using a resuscitation trainer or high-fidelity manikin, learners should be able to: 1) recognize appropriate application of simulated ACCD to an ongoing resuscitation case; 2) demonstrate proper positioning of simulated ACCD in manikin model and 3) integrate simulated ACCD to provide compressions appropriately throughout cardiac arrest scenario.

Cardiology/Vascular Innovations Procedures

Electrical Storm/Refractory Ventricular Tachycardia

Ashley R Tarchione, MD^* and Amrita Vempati, MD^{^}

DOI: https://doi.org/10.21980/J8TS80 Issue 9:2 No ratings yet.

By the end of this simulation, learners should be able to: 1) recognize unstable ventricular tachycardia and initiate ACLS protocol, 2) practice dynamic decision making by switching between various ACLS algorithms, 3) create a thoughtful approach for further management of refractory ventricular tachycardia, 4) interpret electrocardiogram (ECG) with ST-segment elevation (STE) and left bundle branch block (LBBB), 5) appropriately disposition the patient and provide care after return of spontaneous circulation (ROSC), 6) navigate a difficult conversation with the patient’s husband when she reveals that the patient’s wishes were to not be resuscitated.

Cardiology/Vascular Simulation

Managing STEMIs without a Catheterization Lab: A Simulated Scenario to Improve Emergency Clinician Recognition and Execution of Thrombolysis in the Setting of Rural STEMI Management

Scott Schoenborn, MD,^{*^} Anthony F Steratore, MD,^{*^} Adam Hoffman, CHSE,^{*^} Thomas C Marshall, MD,^{*^} Erica B Shaver, MD,^{*^} and Christopher S Kiefer, MD^{*^}

DOI: https://doi.org/10.21980/J8K933 Issue 9:2 No ratings yet.

By the end of this simulation, learners will be able to: 1) diagnose ST elevation myocardial infarction accurately and initiate thrombolysis in the rural setting without timely access to cardiac catheterization; 2) engage the simulated patient in a shared decision-making conversation, clearly outlying the benefits and risks of thrombolysis; 3) identify the indications and contraindications for thrombolysis in ST elevation myocardial infarction; 4) arrange for transfer to a tertiary care center following completion of thrombolysis.

Cardiology/Vascular Simulation