Current Issue

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

Agitated Psychiatric Patient

Brooke M Pabst, MD^*, Cynthia Leung, MD, PhD^*, Jennifer A Frey, PhD^*and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J85352 Issue 5:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) Obtain a relevant focused history and physical examination on the agitated psychiatric patient. 2) Develop a differential for the agitated psychiatric patient, including primary psychiatric conditions and other organic pathologies. 3) Discuss the management of the agitated psychiatric patient, including the different options available for chemical sedation. 4) Prioritize safety of self and staff when caring for an agitated psychiatric patient.

Psychiatry Current Issue Simulation

Cardiac Tamponade

Alan Chu MD^*and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J81D1D Issue 5:4 No ratings yet.

By the end of this simulation session, the learner will be able to: (1) describe a diagnostic differential for dizziness (2) describe the pathophysiology of cardiac tamponade (3) describe the acute management of cardiac tamponade, including fluid bolus and pericardiocentesis (4) describe the electrocardiogram (ECG) findings of pericardial effusion (5) describe the ultrasound findings of cardiac tamponade (6) describe the indications for emergent bedside pericardiocentesis versus medical stabilization and delayed pericardiocentesis for cardiac tamponade (7) describe the procedural steps for pericardiocentesis, and (8) describe your state’s laws regarding disclosure for sentinel events.

Cardiology/Vascular Current Issue Simulation

Owning the Trauma Bay: Teaching Trauma Resuscitation to Emergency Medicine Residents and Nurses through In-situ Simulation

Andrew Bellino, MD^*, Alexandra June Gordon, MD^{^}, Al’ai Alvarez, MD^*and Kimberly Schertzer, MD^*

DOI: https://doi.org/10.21980/J8WK9X Issue 5:4 No ratings yet.

ABSTRACT: Audience: The following two cases were designed to address learning objectives specific to interns, junior residents, and senior residents in emergency medicine, as well as trauma-certified emergency nurses. Introduction: Traumatic and unintentional injuries account for 5.8 million deaths across the globe each year, with a high proportion of those deaths occurring within the initial hour from the time of

Current Issue Simulation Trauma

Simulated Mass Casualty Incident Triage Exercise for Training Medical Personnel

Alaina Brinley Rajagopal, MD, PhD^*, Nathan Jasperse, BS^* and Megan Boysen Osborn, MD, MHPE^*

DOI: https://doi.org/10.21980/J82H1R Issue 5:4 No ratings yet.

By the end of this exercise, learners should be able to (1) recite the basic START patient categories (2) discuss the physical exam signs associated with each START category, (3) assign roles to medical providers in a mass casualty scenario, (4) accurately categorize patients into triage categories: green, yellow, red, and black, and (5) manage limited resources when demand exceeds availability.

EMS Current Issue Small Group Learning Trauma

Thyroid Storm

Kathryn Ritter, MD^* and Carmen Wolfe, MD^*

DOI: https://doi.org/10.21980/J8RW71 Issue 5:4 No ratings yet.

At the end of this practice oral boards case, the learner will: 1) assess a patient with altered mental status in an oral boards format; 2) review appropriate laboratory testing and diagnostic imaging; 3) identify signs and symptoms of thyroid storm and 4) review appropriate pharmacologic therapies with the proper sequence and timing.

Endocrine Current Issue Oral Boards

Necrotizing Fasciitis and Mediastinitis after Wisdom Tooth Extraction: A Case Report

Jennifer Edwards, MD^*, Ryan Fisher, MD^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8XW7KIssue 5:4 No ratings yet.

Computer tomography (CT) imaging of soft tissues of the neck and of the chest/abdomen/pelvis revealed extensive swelling and subcutaneous air (see red arrows) on the left side of the face and neck extending to the left shoulder, as well as parapharyngeal/retropharyngeal spaces and posterior/superior mediastinum.

Current Issue Infectious Disease Visual EM

Adult Clavicular Fracture Case Report

Jessica L Sea, PhD^*, Nadia Zuabi, MD^* and Alisa Wray, MD, MAEd^*

DOI: https://doi.org/10.21980/J8FM0TIssue 5:4 No ratings yet.

The patient's chest and clavicular radiographs showed a comminuted displaced acute fracture of the right mid-clavicle (green, blue, yellow). The clavicular fracture was also visible on the chest computed tomography (CT). The remainder of his trauma workup was negative for acute findings.

Orthopedics Current Issue Trauma Visual EM

DRUJ Elbow Xray, Lateral. Unannotated. JETem 2020

Case Report of Distal Radioulnar Joint and Posterior Elbow Dislocation

Danielle Matonis, MD^*, Katelyn Wittel, BS^* and Alisa Wray, MD, MAEd^*

DOI: https://doi.org/10.21980/J89S6K Issue 5:4 No ratings yet.

Radiographs of the left elbow and wrist were obtained. Left elbow radiographs showed simple posterolateral dislocation of the olecranon (red) without fracture of the olecranon (red) or trochlea (blue). Left wrist lateral radiographs demonstrated DRUJ dislocation with dorsal displacement of the distal ulna (green) without fracture or widening of the radioulnar joint (purple). Post-reduction radiographs demonstrated appropriate alignment of the elbow with the trochlea seated in the olecranon and improved alignment of the DRUJ.

Orthopedics Current Issue Trauma Visual EM

Bladder Diverticulum – A Case Report

Savannah Tan, BS^* and Sangeeta Sakaria, MD, MPH, MST^*

DOI: https://doi.org/10.21980/J8635C Issue 5:4 No ratings yet.

On examination, the patient was alert and oriented but in mild distress. Suprapubic fullness was noted upon abdominal palpation. Point of care ultrasound of the bladder showed two enlarged “bladders” with a central communication. Bedside total bladder volume was measured to be 1288 cm3 (the top “bladder” was measured to be 1011 cm3, while the bottom “diverticulum” was measured to be 277 cm3) by ultrasound. The POCUS stills of the patient’s bladder demonstrated the bladder (red arrow) and bladder diverticulum (yellow arrow) with a central communication (blue arrow) in the transverse and sagittal views.

Renal/Electrolytes Current Issue Ultrasound Visual EM