Simulation

Acute Exacerbation of COPD

Dominic Pappas, MD^*and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8V070 Issue 8:2 No ratings yet.

By the end of this simulation, learners will be able to (1) assess for causes of severe shortness of breath, (2) manage severe COPD exacerbation by administering appropriate medications, (3) identify worsening clinical status and initiate NIPPV, (4) assess the causes of hypoxia after establishing endotracheal intubation and, (5) identify indication for needle decompression and perform chest tube thoracostomy.

Respiratory Simulation

Botulism due to Drug Use

Timothy Hoffman, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8Q93B Issue 8:2 No ratings yet.

ABSTRACT: Audience: This scenario was developed to educate emergency medicine residents on the diagnosis and management of wound botulism secondary to injection drug use. Introduction: Botulism is a relatively rare cause of respiratory failure and descending weakness in the United States, caused by prevention of presynaptic acetylcholine release at the neuromuscular junction. This presentation has several mimics, including myasthenia gravis

Simulation Toxicology

Telemedicine Consult for Shortness of Breath Due to Sympathetic Crashing Acute Pulmonary Edema

Derek Jacob Carver Hunt, DO^*, Kevin McLendon, DO^*, Carl Johns III, DO^* and Daniel Crane, MD^*

DOI: https://doi.org/10.21980/J8HS86 Issue 8:1 No ratings yet.

At the completion of the simulation and debriefing, the learner will be able to: 1) recognize the physical exam findings and presentation of SCAPE, 2) utilize imaging and laboratory results to further aid in the diagnosis of SCAPE, 3) initiate treatments necessary for the stabilization of SCAPE, 4) demonstrate the ability to assist with the stabilization and disposition of a patient via tele-medicine as determined by the critical action checklist and assessment tool below, 5) interpret the electrocardiogram (EKG) as atrial fibrillation with rapid ventricular response (AFRVR), and 6) recognize that SCAPE is the underlying cause of AFRVR and continue to treat the former.

Respiratory Clinical Informatics, Telehealth and Technology Simulation

Anticholinergic Toxicity in the Emergency Department

C Eric McCoy, MD, MPH^* and Reid Honda, MD^{^}

DOI: https://doi.org/10.21980/J8D07Z Issue 8:1 No ratings yet.

By the end of this simulation case, learners will be able to: 1) describe the classic clinical presentation of anticholinergic toxicity, 2) discuss common medications and substances that may lead to anticholinergic toxicity, 3) recognize the electrocardiogram (ECG) findings in anticholinergic toxicity that require specific therapy, and 4) review the management of anticholinergic toxicity.

Toxicology Simulation

Methemoglobinemia

Ibrahim Alagha, BS^*, Ghadeer Doman, MD^{^}and Shaza Aouthmany, MD^†

DOI: https://doi.org/10.21980/J8PH1B Issue 7:4 No ratings yet.

At the end of this simulation case, participants should be able to: 1) recognize shortness of breath, cyanosis and respiratory distress, and the difference between all of them based on the clinical presentation 2) identify the underlying cause of the condition by conducting a thorough history and physical 3) know how to identify and treat methemoglobinemia by ordering necessary labs and interventions and understand the pathophysiology leading to methemoglobinemia 4) recognize patient’s response to treatment and continue to reassess.

Toxicology Simulation

Torsade de Pointes Due to Hypokalemia and Hypomagnesemia

Mary Crista Cabahug^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8JP8G Issue 7:4 No ratings yet.

By the end of this simulation session, learners will be able to: 1) formulate appropriate work-up for altered mental status (AMS) 2) recognize hypokalemia and associated findings on ECG 3) address hypomagnesemia in a setting to hypokalemia 4) manage pulseless VT by following advanced cardiac life support (ACLS) 5) recognize and address TdP 6) provide care after return of spontaneous circulation (ROSC) 7) consult intensivist and admit to intensive care unit (ICU).

Cardiology/Vascular Simulation

Cyanide Poisoning

Ghadeer Doman, MD^*, Jihad Aoun, MS^{^}, Joshua Truscinski, MS^{^}, Mariah Truscinski, MD^{^} and Shaza Aouthmany, MD^{^}

DOI: https://doi.org/10.21980/J80W76 Issue 7:3 No ratings yet.

After the completion of this simulation, participants will have learned how to: 1) identify clues of smoke inhalation based on a physical examination; 2) identify smoke inhalation-induced airway compromise and perform definitive management; 3) create a differential diagnosis for victims of fire cyanide poisoning, carbon monoxide, and carbon dioxide; 4) appropriately treat cyanide poisoning; 5) demonstrate the importance of preemptively treating for cyanide poisoning; 6) perform an initial physical examination and identify physical marks suggesting the patient is a fire and smoke inhalation victim; and 7) familiarize themselves with the Cyanokit and treatment with hydroxocobalamin.

Toxicology Simulation

Aortic Dissection Presenting as a STEMI

Jennifer Yee, DO^* and Andrew P Kendle, MD^*

DOI: https://doi.org/10.21980/J8W647 Issue 7:3 No ratings yet.

At the conclusion of the simulation session or during the debriefing session, learners will be able to: 1) Verbalize the anatomical differences and management of Stanford type A and type B aortic dissections, 2) Describe physical exam findings that may be found with ascending aortic dissections, 3) Describe the various clinical manifestations of the propagation of aortic dissections, 4) Discuss the management of aortic dissection, including treatment and disposition.

Cardiology/Vascular Simulation

Breaking Bad News in the Emergency Department

Susan Siraco, BA^*, Cindy Bitter, MD, MPH, MA^{^} and Tina Chen, MD^{^}

DOI: https://doi.org/10.21980/J81W7H Issue 7:2 No ratings yet.

At the conclusion of these two simulation cases, learners will be able to 1) recognize signs of poor prognosis requiring emergent family notification, 2) take practical steps to contact family using available resources and personnel, 3) establish goals of care through effective family discussion, 4) use a structured approach, such as GRIEV_ING, to deliver bad news to patients’ families, and 5) name the advantages of family-witnessed resuscitation.

Miscellaneous (stats, etc)Simulation

Infant Botulism

Victoria Morris, MD^*, Robert Wians, MD, MPH^*, Jessica Wilson, MD^* and Gowri Stevens, MD^*

DOI: https://doi.org/10.21980/J8X35W Issue 7:2 No ratings yet.

After this simulation learners should be able to: 1) develop a differential diagnosis for the hypotonic infant, 2) recognize signs and symptoms of infant botulism, 3) recognize respiratory failure and secure the airway with appropriate rapid sequence intubation (RSI) medications, 4) initiate definitive treatment of infant botulism by mobilizing resources to obtain antitoxin, 5) continue supportive management and admit the patient to the pediatric intensive care unit (PICU), 6) understand the pathophysiology and epidemiology of infant botulism, 7) develop communication and leadership skills when evaluating and managing critically ill infants.

Pediatrics Simulation Toxicology