Archives

Adolescent with Diabetic Ketoacidosis, Hypothermia and Pneumomediastinum

Steven Millner, MD^* and Courtney Devlin, MD^*

DOI: https://doi.org/10.21980/J8FP8J Issue 8:4 No ratings yet.

By the end of the simulation, learners will be able to: 1) develop a differential diagnosis for an adolescent who presents obtunded with shortness of breath; 2) discuss the management of diabetic ketoacidosis; 3) discuss management of hypothermia in a pediatric patient; 4) discuss appropriate ventilator settings in a patient with diabetic ketoacidosis; and 5) demonstrate interpersonal communication with family, nursing, and consultants during high stress situations.

Ventricular Tachycardia

Rohit Menon, MD^*, Geremiha Emerson, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8KD2R Issue 8:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) identify the different etiologies of VT, including structural heart disease, acute ischemia, and acquired or congenital QT syndrome; 2) describe confounding factors of VT, such as electrolyte abnormalities and sympathetic surge; 3) describe how to troubleshoot an unsuccessful synchronized cardioversion, including checking equipment connections, increasing delivered energy, and changing pad placement; 4) compare and contrast treatments of VT based on suspected underlying etiology; 5) describe reasons to activate the cardiac catheterization lab other than occlusive myocardial infarction; and 6) identify appropriate disposition of the patient to the cardiac catheterization lab.

Cardiology/Vascular Current Issue Simulation

Inhalational Injury Secondary to House Fire

Ryan O’Neill, MD^*, Benjamin M Ostro, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8TW7N Issue 8:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) recognize the indications for intubation in a thermal burn/inhalation injury patient; 2) develop a systematic approach to an inhalational injury airway; and 3) recognize indications for transfer to burn center.

Respiratory Current Issue Procedures Simulation

Alcohol Withdrawal with Delirium Tremens

Courtney Schwebach, MD^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8S35N Issue 8:3 No ratings yet.

By the end of the session, learner will be able to 1) discuss the causes of altered mental status, 2) utilize CIWA scoring system to quantify AW severity, 3) formulate appropriate treatment plan for AW by treating with benzodiazepine and escalating treatment appropriately, 4) treat electrolyte abnormalities by giving appropriate medications for hypokalemia and hypomagnesemia, and 5) discuss clinical progression and timing to AW.

Simulation Toxicology

Headache Over Heels: CT Negative Subarachnoid Hemorrhage

Sarah Hogan, MD^*, Sara Dimeo, MD, MEHP^{^} and Caroline Astemborski, MD, MEHP^*

DOI: https://doi.org/10.21980/J8ND2C Issue 8:3 No ratings yet.

By the end of this case, the participant will be able to: 1) construct a broad differential diagnosis for a patient presenting with syncope, 2) name the history and physical exam findings consistent with SAH, 3) identify SAH on computer tomography (CT) imaging, 4) identify the need for lumbar puncture (LP) to diagnose SAH when CT head is non-diagnostic > 6 hours after symptom onset, 5) correctly interpret cerebral fluid studies (CSF) to aid in the diagnosis of SAH, and 6) specify blood pressure goals in SAH and suggest appropriate medication management.

Neurology Simulation

Peripartum Cardiomyopathy

Victoria L Morris, MD^*, Carolina Mendoza, MD^*, Gowri S Stevens, MD^*, Jessica L Wilson, MD^*and Adeola A Kosoko, MD^*

DOI: https://doi.org/10.21980/J8ZS9M Issue 8:2 No ratings yet.

By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy.

Cardiology/Vascular Ob/Gyn 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