Procedures

Modified Manikin for Tracheoinnominate Artery Fistula

Emily M Tarver, MD*, Gina D Jefferson, MD, MPH ^, Patrick Parker‡, Kristina Readman‡, Susana M Salazar Marocho, BDS, PhD** and Anna A Lerant, MD, CHSE‡^^

DOI: https://doi.org/10.21980/J8Z93H Issue 6:3[mrp_rating_result]
By 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.
InnovationsProceduresRespiratory

Tracheoinnominate Artery Fistula

Emily M Tarver, MD*, Anna A Lerant, MD, CHSE^, Jeffrey D Orledge, MD*, Benjamin P Stevens, MD‡, and Gina D Jefferson, MD, MPH, FACS‡

DOI: https://doi.org/10.21980/J8K05R Issue 6:3[mrp_rating_result]
By 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.
ProceduresRespiratorySimulation

A Low-Cost Facial and Dental Nerve Regional Anesthesia Task Trainer

Andrew Eyre, MD, MSHPed*^ and Valerie Dobiesz, MD, MPH*^

DOI: https://doi.org/10.21980/J8RP9Q Issue 6:2[mrp_rating_result]
By 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.
ProceduresENTInnovations

An Ultrasound-Guided Regional Anesthesia Elective for Emergency Medicine Residents

Ryan V Tucker, MD*, Robert Huang, MD*, William J Peterson, MD*, Brendan W Munzer, MD* and Molly Thiessen, MD^

DOI: https://doi.org/10.21980/J8TP9B Issue 6:1[mrp_rating_result]
ABSTRACT: Audience: This ultrasound-guided regional anesthesia elective is designed for emergency medicine residents. Length of Curriculum: The proposed length of this curriculum is over one week. Introduction: Ultrasound-guided regional anesthesia (UGRA) is a useful tool in the emergency department (ED) for managing painful conditions, and many programs have identified that these are useful skills for emergency providers; however, only about
ProceduresCurriculaUltrasound

Design and Implementation of a Low-Cost Priapism Reduction Task Trainer

Andrew Eyre, MD, MSHPed*^ and Valerie Dobiesz, MD, MPH*^

DOI: https://doi.org/10.21980/J8K64F Issue 6:1[mrp_rating_result]
By the end of this educational session, learners should be able to 1) Verbalize the difference between low-flow and high-flow priapism 2) Describe the landmarks for a penile ring block and cavernosal aspiration/injection 3) Demonstrate the appropriate technique for performing a penile ring block, cavernosal aspiration, and cavernosal injection.
InnovationsProceduresUrology

Improving Emergency Department Airway Preparedness in the Era of COVID-19: An Interprofessional, In Situ Simulation

Keiran J Warner, MD*, Ashley C Rider, MD*, James Marvel, MD*, Michael A Gisondi, MD*, Kimberly Schertzer, MD* and Kelly N Roszczynialski, MD, MS*

DOI: https://doi.org/10.21980/J8V06M Issue 5:3[mrp_rating_result]
At the conclusion of the simulation session, learners will be able to: 1) Understand the need to notify team members of a planned COVID intubation including: physician, respiratory therapist, pharmacist, nurse(s), and ED technician. 2) Distinguish between in-room and out-of-room personnel during high-risk aerosolizing procedures. 3) Distinguish between in-room and out-of-room equipment during high-risk aerosolizing procedures to minimize contamination. 4) Appropriately select oxygenation therapies and avoid high-risk aerosolizing procedures. 5) Manage high risk scenarios such as hypotension or failed intubation and be prepared to give push-dose vasoactive medications or place a rescue device such as an I-gel®.
Infectious DiseaseProceduresRespiratorySimulation

Low Fidelity Trainer for Fiberoptic Scope Use in the Emergency Department

Garren Giles, DO*, Dominic Diprinzio, DO* and Jordana Haber, MD*

DOI: https://doi.org/10.21980/J8764B Issue 5:3[mrp_rating_result]
By the end of this training session, learners will be able to 1) list indications, contraindication, and complications in performing fiberoptic intubations, 2) know how to use and maneuver a fiberoptic scope, and 3) be able to successfully intubate the trainer model.
ProceduresInnovationsRespiratory

An Innovative Inexpensive Portable Pulmonary Edema Intubation Simulator

Joshua D Mastenbrook, MD*, Neil C Hughes, MD^, William D Fales, MD* and David T Overton, MD*

DOI: https://doi.org/10.21980/J8MM1R Issue 5:2[mrp_rating_result]
By the end of the session, learners will be able to: 1. Discuss the pathophysiology of, and immediate stabilization management steps for, acute cardiogenic pulmonary edema. 2. List the indications, contraindications, and risks associated with intubating a patient with acute cardiogenic pulmonary edema. 3. Demonstrate effective communication and teamwork skills to manage the airway of a simulated patient in respiratory distress due to acute cardiogenic pulmonary edema. 4. Successfully and safely intubate a simulated patient with a difficult airway due to visual obstruction from frothy pulmonary edema secretions.
ProceduresInnovationsRespiratory