Archives

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.
Current IssueMiscellaneous (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. 
Current IssuePediatricsSimulationToxicology

Lightning Strike

Thomas Powell, MD*, Aubri Charnigo, MD* and Jennifer Yee, DO* 

DOI: https://doi.org/10.21980/J8SD2M Issue 7:2 No ratings yet.
At 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.
Current IssueSimulationWilderness

Massive Upper Gastrointestinal Bleeding

Eytan Shtull-Leber, MD, MSCR*, Amrita Vempati, MD^, Geoff Comp, DO^ and Aneesh T Narang, MD*

DOI: https://doi.org/10.21980/J8W93W Issue 7:1 No ratings yet.
By 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.
Abdominal/GastroenterologyLectures

Syncope Due to a Ruptured Ectopic Pregnancy

Derek JC Hunt, DO*, Kevin McLendon, DO* and Jodi Conrad, DO*

DOI: https://doi.org/10.21980/J86M0N Issue 7:1 No ratings yet.
At 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.
Ob/GynSimulation

Small-Scale High-Fidelity Simulation for Mass Casualty Incident Readiness

Seanne Facho, MD*, Andrea Weiers, MD*, Amber Jones, MD*, Sage Wexner, MD* and Jessie Nelson, MD^

DOI: https://doi.org/10.21980/J84S8S Issue 6:4 No ratings yet.
The 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.
EMSSimulation

Cardiac Arrest in an Adolescent with Pulmonary Embolism

Matthew Myers, DO* and Courtney Devlin, MD*

DOI: https://doi.org/10.21980/J8135T Issue 6:4 No ratings yet.
ABSTRACT: 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
Cardiology/VascularPediatricsSimulation

Meningococcal Meningitis with Waterhouse-Friderichsen Syndrome

Jonathan Kelley, DO* and Amrita Vempati, MD*

DOI: https://doi.org/10.21980/J8TH1K Issue 6:3 No ratings yet.
By 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.
Infectious DiseaseNeurologySimulation

Eclampsia

Thomas J Yang, MD*, Rohit B Sangal, MD, MBA* and Lauren W Conlon, MD^

DOI: https://doi.org/10.21980/J8PS8R Issue 6:3 No ratings yet.
By 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.
Ob/GynSimulation

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 No ratings yet.
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