Archives
Breaking Bad News in the Emergency Department
DOI: https://doi.org/10.21980/J81W7HAt 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.
Infant Botulism
DOI: https://doi.org/10.21980/J8X35WAfter 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.
Lightning Strike
DOI: https://doi.org/10.21980/J8SD2MAt the conclusion of the simulation session, learners will be able to: 1) Describe how to evaluate for scene safety in an outdoor space during a thunderstorm, 2) Obtain a relevant focused physical examination of the lightning strike patient, 3) Describe the various manifestations of thermo-electric injury, 4) Discuss the management of the lightning strike patient, including treatment and disposition, 5) Outline the principles of reverse triage for lightning strike patients, and 6) Describe long-term complications of lightning strike injuries.
Massive Upper Gastrointestinal Bleeding
DOI: https://doi.org/10.21980/J8W93WBy the end of this simulation, learners will be able to: 1) manage a hypotensive patient with syncope and hematemesis, 2) pharmacologically manage an acute UGIB addressing the various causes, 3) recognize worsening clinical status and intervene by performing difficult airway management, 4) place a gastroesophageal balloon tamponade device.
Syncope Due to a Ruptured Ectopic Pregnancy
DOI: https://doi.org/10.21980/J86M0NAt the conclusion of this simulation, the learner will be able to: 1) review the initial management of syncope; 2) utilize laboratory and imaging techniques to diagnose a ruptured ectopic pregnancy; and 3) demonstrate the ability to resuscitate and disposition an unstable ruptured ectopic pregnancy.
Small-Scale High-Fidelity Simulation for Mass Casualty Incident Readiness
DOI: https://doi.org/10.21980/J84S8SThe learners will (1) recognize state of mass casualty exercise as evidenced by verbalization or triaging by START (Simple Triage and Rapid Treatment) criteria, (2) triage several patients, including critically ill or peri-arrest acuities, according to START criteria, (3) recognize the need to limit care based on available resources, as evidenced by verbal orders or communication of priorities to team, and (4) limit emergency resuscitation, given limited resources, by only providing treatments and employing diagnostics that do not deplete limited time, staffing, and space inappropriately.
Cardiac Arrest in an Adolescent with Pulmonary Embolism
DOI: https://doi.org/10.21980/J8135TABSTRACT: Audience: The target audience of this simulation is emergency medicine residents and medical students. The simulation is based on a real case of a 13-year-old female who presented with seizures and hypoxia and was ultimately diagnosed with pulmonary embolism. The case highlights diagnosis and management of an adolescent with new onset seizures, deterioration in status, and treatment options in
Meningococcal Meningitis with Waterhouse-Friderichsen Syndrome
DOI: https://doi.org/10.21980/J8TH1KBy the end of this simulation session, learners will be able to: (1) manage a patient with altered mental status (AMS) with fever while maintaining a broad differential diagnosis, (2) recognize the risk factors for meningococcal meningitis, (3) manage a patient with worsening shock and perform appropriate resuscitation, (4) develop a differential diagnosis for thrombocytopenia and elevated international normalized ratio (INR) in an altered febrile hypotensive patient with rash, (5) manage the bleeding complications from WFS, (6) discuss the complications of meningococcal meningitis including WFS, and (7) review when meningitis prophylaxis is given.
Eclampsia
DOI: https://doi.org/10.21980/J8PS8RBy the end of this simulation session, learners will be able to: 1) demonstrate care of a gravid patient with altered mental status; 2) demonstrate care of a gravid patient with seizures; 3) recognize care involved in assessment of fetal status; 4) execute appropriate subspecialty consultation; 5) recognize the clinical signs and symptoms of eclampsia; 6) distinguish different treatment options for eclampsia; 7) identify magnesium toxicity and reversal agent; and 8) differentiate the spectrum of preeclampsia.
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.