Archives

My Broken Heart

Kelly N Roszczynialski, MD, MS^*, Alana E Harp, MD^{^}, Cameron A Fisk, MD^*,Kristen M Ng, MD, MEHP^† and Ashley C Rider, MD, MEHP^*

DOI: https://doi.org/10.21980/J85W7RIssue 10:2 No ratings yet.

By the end of this simulation session, learners will be able to: 1) assess the hemodynamics of an LVAD patient by using a Doppler to determine mean arterial pressure, 2) Manage an arrhythmia in an LVAD patient with a suction event by addressing preload, 3) Identify and treat the source of hypovolemia (a massive lower gastrointestinal hemorrhage), 4) Perform clear closed-loop communication with other team members.

Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation

Matthew Heffernan, MD^{*^}, Jennifer Quinn, MSN^{*^}, Craig Tschautscher, MD^{*^}, Ryan Newberry, DO^{*^}, Andrew Cathers, MD^{*^} and Brittney Bernardoni, MD^{*^}

DOI: https://doi.org/10.21980/J82354 Issue 10:2 No ratings yet.

ABSTRACT: Audience: This simulation is designed for critical care transport providers but can be easily adapted for the inpatient setting. It is applicable to an interdisciplinary team including nurses, respiratory therapists, medical students, emergency medicine residents, and emergency medicine attendings. Introduction: Cardiogenic shock carries an incredibly high burden of morbidity and mortality. Acute myocardial infarction accounts for 81% of cardiogenic

Current Issue Cardiology/Vascular EMS Simulation

A Cold Case: Myxedema Coma

Andrew M Namespetra, MD^*, Matthew J Petruso, DO^* and Andrew M Bazakis, MD^*

DOI: https://doi.org/10.21980/J8VM0J Issue 10:1 No ratings yet.

At the conclusion of the simulation, the learner is expected to: 1) Recognize the key features on history and examination of a patient presenting in myxedema coma and initiate the appropriate workup and treatment, 2) Describe clinical features and management for a patient with myxedema coma, 3) Develop a differential diagnosis for a critically ill patient with altered mental status, 4) Discuss the management of myxedema coma in the ED, including treatments, appropriate consultation, and disposition.

Endocrine Simulation

Drowning Complicated by Hypothermia

Alexander Close, MD^*and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8QS7P Issue 10:1 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) obtain a relevant focused history, including circumstances of drowning and/or cold exposure; 2) outline different clinical presentations of hypothermia, loosely correlated with core temperature readings; 3) discuss management of hypothermia, including passive external rewarming, active external rewarming, active internal rewarming, and extracorporeal blood rewarming; 4) discuss pathophysiology of drowning; 5) identify appropriate disposition of patients who present after drowning; and 6) identify appropriate disposition of hypothermic patients.

Cardiology/Vascular Simulation Wilderness

A Case of Painful Visual Loss – Managing Orbital Compartment Syndrome in the Emergency Department

Jessica Pelletier, DO^*, Alexander Croft, MD^*, Michael Pajor, MD^*, Matthew Santos, MD^{^}, Douglas Char, MD^*, Marc Mendelsohn, MD, MPH^*, and Ernesto Romo, MD^*

DOI: https://doi.org/10.21980/J8N35D Issue 9:4 No ratings yet.

By the end of this simulation, learners will be able to: 1) demonstrate the major components and a systematic approach to the emergency ophthalmologic examination, 2) develop a differential diagnosis of sight-threatening etiologies that could cause eye pain or vision loss, 3) demonstrate proficiency in performing potentially vision-saving procedures within the scope of EM practice.

Ophthalmology Simulation

Going in Blind: A Common Scenario in an Uncommon Situation

Ethan Hartman, MD^* and Kimberly Sokol, MD, MS, MACM^*

DOI: https://doi.org/10.21980/J8RS8C Issue 9:4 No ratings yet.

By the end of this simulation, learners will be able to (1) evaluate and treat a patient experiencing myocardial infarction and subsequent cardiac arrest during a power outage, (2) describe the local protocols for managing patient care during a power outage, (3) demonstrate the ability to coordinate a medical team during a simulated power outage in an emergency department with limited resources, (4) manage a cardiac arrest patient by following Advanced Cardiac Life Support (ACLS) protocols for bradycardia and ventricular fibrillation, and (5) justify the urgency of transfer to a certified ST segment elevation myocardial infarction center/cardiac intensive care unit, referencing the recommended 120-minute door-to-balloon time.

Cardiology/Vascular Miscellaneous (stats, etc)Simulation

Identification of a Human Trafficking Victim: A Simulation

Claire A Grosgogeat, BS^*, Kelly Medwid, MD^{^}, Rami H Mahmoud, BS^* and Brooke Hensley, MD^{^}

DOI: https://doi.org/10.21980/J8293F Issue 9:3 No ratings yet.

By the end of this simulation, participants will be able to: (1) Identify signs of human trafficking. (2) Demonstrate the ability to perform a primary and secondary assessment of a patient when there is concern for human trafficking. (3) Demonstrate the ability to appropriately separate an at-risk patient from a potential trafficker. (4) Identify resources and a reliable course of action to permanently remove the patient from the harmful situation.

Miscellaneous (stats, etc)Simulation

Subarachnoid Hemorrhage Causing a Seizure: An Assessment Simulation for Medical Students

Robert Rainer, MD^*, Blair Creedle Reynolds, MD^*, Cyrus Adeli^{^} and Christopher E San Miguel, MD, MEd^*

DOI: https://doi.org/10.21980/J8XH1H Issue 9:3 No ratings yet.

At the conclusion of the simulation leaners will be able to: 1) efficiently take a history from the patient and perform a physical exam (including a complete neurological exam); 2) identify red flag symptoms in a patient complaining of a headache; 3) order and interpret the results of a CT of the head and either a CT angiogram of the brain or a lumbar puncture to make the diagnosis of subarachnoid hemorrhage; 4) demonstrate appropriate management of a seizure; and 5) utilize the I-PASS framework to communicate with the inpatient team during the transition of care.

Neurology Simulation

High-Fidelity Simulation with Transvaginal Ultrasound in the Emergency Department

Levi Filler, DO^* and Katrina Lettang, MD^*

DOI: https://doi.org/10.21980/J8606Q Issue 9:3 No ratings yet.

By the end of the session, learners should be able to 1) recognize the clinical indications for transvaginal ultrasound in the ED, 2) practice the insertion, orientation, and sweeping motions used to perform a TVPOCUS study, 3) interpret transvaginal ultrasound images showing an IUP or alternative pathologies, and 4) understand proper barrier, disinfection, and storage techniques for endocavitary probes.

Ob/Gyn Procedures Simulation

Septic Abortion Complicated by Disseminated Intravascular Coagulation

Lauren Moore, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8GH1G Issue 9:2 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) Obtain a relevant focused history including pregnancy history, medication use, and past medical history. 2) Develop a differential for fever and vaginal bleeding in a pregnant patient. 3) Discuss management of septic abortion, including empiric broad-spectrum antibiotics and obstetric consultation for source control with dilation and curettage (D&C). 4) Discuss expected laboratory findings of disseminated intravascular coagulation (DIC). 5) Discuss management of DIC, including identification of underlying etiology and supportive resuscitation with blood products. 6) Review the components of blood products. 7) Identify appropriate disposition of the patient to the intensive care unit (ICU).

Hematology/Oncology Infectious Disease Ob/Gyn Simulation