Procedures
How to Build a Low-Cost Video-Assisted Laryngoscopy Suite for Airway Management Training
DOI: https://doi.org/10.21980/J8C068Using an anatomically accurate airway simulator, by the end of a 20–30-minute instructional session, learners should be able to: 1) Understand proper positioning and use the video laryngoscope with dexterity, 2) identify airway landmarks via the video screen, and 3) demonstrate ability to intubate a simulated airway.
Construction of Soft Prep Cadaver Pericardiocentesis Training Model and Implementation Among Emergency Medicine Residents
DOI: https://doi.org/10.21980/J87930By the end of this session, residents will gain increased procedural competence and confidence with pericardiocentesis. Residents will be able to identify necessary supplies for the procedure, identify relevant surface anatomy and ultrasound views, and successfully aspirate fluid from model effusion.
A Man with Sore Throat—A Case Report
DOI: https://doi.org/10.21980/J8MH0BVideo laryngoscopy of the upper airway was performed two days after initial burn injury. The images obtained demonstrated laryngeal edema and inflammation near the epiglottis. The dot identifies the epiglottis and the asterix identifies the area of moderate thermal burns. Imaging also demonstrated adequate patency of airway and ruled out the need for intubation at that time.
High-Efficiency Ultrasound-Guided Regional Nerve Block Workshop for Emergency Medicine Residents
DOI: https://doi.org/10.21980/J84P8RThe objective of this workshop is to provide emergency medicine residents the confidence and skill sets needed to effectively perform five commonly used UGRNBs for conditions encountered in the emergency department. Through this one-day, accelerated workshop, residents will be given an opportunity to sharpen their UGRNB technique prior to applying them in the clinical environment. By the end of this workshop, learners will be able to: 1) recognize the clinical situations in which UGRNBs can be utilized and understand the associated risks, 2) list the commonly used local anesthetic medications and their proper dosing in respect to regional nerve blocks, 3) demonstrate proper ultrasound probe positioning and identify relevant anatomical landmarks for each nerve block on both standardized patients and cadavers, 4) describe the common steps involved to perform each nerve block, 5) perform the five UGRNB techniques outlined in this workshop.
Evaluation of ACE-inhibitor Induced Laryngeal Edema Using Fiberoptic Scope: A Case Report
DOI: https://doi.org/10.21980/J83P9TPhysical exam was initially significant for swelling isolated to the right sided cheek and upper lip. There was no edema to lower lip, uvular swelling, or swelling to the submandibular space. She was speaking full sentences and did not endorse any voice changes. Initial vital signs were as follows: BP 125/77, HR 74, RR 16, and oxygen saturation of 100% on room air. Approximately 40 minutes later, after 125 mg solumedrol intravenous (IV) and 50mg diphenhydramine by mouth, swelling had spread to the entire upper lip and the patient reported spreading to her jaw (Photo 1). Although no jaw or submandibular edema was appreciated on physical exam, a flexible fiberoptic laryngoscope was used to evaluate the patient’s airways given worsening symptoms. Viscous lidocaine was applied intranasally five minutes prior to the procedure. The patient was positioned in a seated position on the stretcher. A flexible fiberoptic laryngoscope was then inserted through the nares and advanced slowly. Laryngoscopy showed diffuse edema of the epiglottis, arytenoids, and ventricular folds (see photos 2-4). Vital signs and respiratory status remained stable both during and after the procedure.
Peritonsillar Abscess Simulator: A Low-Cost, High-Fidelity Trainer
DOI: https://doi.org/10.21980/J85M0BBy the end of this training session, learners will be able to: 1) locate the abscess, 2) perform needle aspiration, and 3) develop dexterity in maneuvering instruments in the small three-dimensional confines of the oral cavity without causing injury to local structures.
The Zipperator! A Novel Model to Simulate Penile Zipper Entrapment
DOI: https://doi.org/10.21980/J8NS8FAfter training on the Zipperator, learners will be able to: 1) demonstrate at least two techniques for zipper release and describe how methods would extrapolate to a real patient; 2) verbalize increased comfort with the diagnosis of zipper entrapment; and 3) present a plan of care for this low-volume, high-anxiety presentation.
Modified Manikin for Tracheoinnominate Artery Fistula
DOI: https://doi.org/10.21980/J8Z93HBy the end of this educational session, learners will be able to: 1) perform a focused history and physical exam on any patient who presents with bleeding from the tracheostomy site; 2) describe the differential diagnosis of bleeding from a tracheostomy site, including a TIAF; 3) demonstrate the stepwise management of bleeding from a suspected TIAF, including cuff hyperinflation and the Utley Maneuver; 4) verify that definitive airway control via endotracheal intubation is only feasible in the tracheostomy patient when it is clear, upon history and exam, that the patient can be intubated from above; and 5) demonstrate additional critical actions in the management of a patient with a TIAF, including early consultation with otolaryngology and cardiothoracic surgery as well as emergent blood transfusion and activation of a massive transfusion protocol.
Tracheoinnominate Artery Fistula
DOI: https://doi.org/10.21980/J8K05RBy the end of this simulation, learners will be able to: 1) perform a focused history and physical exam on any patient who presents with bleeding from the tracheostomy site, 2) describe the differential diagnosis of bleeding from a tracheostomy site, including a TIAF, 3) demonstrate the stepwise management of bleeding from a suspected TIAF, including cuff hyperinflation and the Utley Maneuver, 4) verify that definitive airway control via endotracheal intubation is only feasible in the tracheostomy patient when it is clear, upon history and exam, that the patient can be intubated from above, 5) demonstrate additional critical actions in the management of a patient with a TIAF, including early consultation with otolaryngology and cardiothoracic surgery as well as emergent blood transfusion and activation of a massive transfusion protocol.
A Low-Cost Facial and Dental Nerve Regional Anesthesia Task Trainer
DOI: https://doi.org/10.21980/J8RP9QBy the end of this educational session, learners should be able to: 1) describe and identify relevant anatomy for supra-orbital, infra-orbital, mental, and inferior alveolar nerves and 2) successfully demonstrate supra-orbital, infra-orbital, mental, and inferior alveolar nerve blocks using a partial task trainer.