Archives

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[mrp_rating_result]
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.
OphthalmologySimulation

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[mrp_rating_result]
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/VascularMiscellaneous (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[mrp_rating_result]
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[mrp_rating_result]
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.
NeurologySimulation

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[mrp_rating_result]
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/GynProceduresSimulation

Septic Abortion Complicated by Disseminated Intravascular Coagulation

Lauren Moore, MD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J8GH1G Issue 9:2[mrp_rating_result]
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/OncologyInfectious DiseaseOb/GynSimulation

Electrical Storm/Refractory Ventricular Tachycardia

Ashley R Tarchione, MD* and Amrita Vempati, MD^

DOI: https://doi.org/10.21980/J8TS80 Issue 9:2[mrp_rating_result]
By the end of this simulation, learners should be able to: 1) recognize unstable ventricular tachycardia and initiate ACLS protocol, 2) practice dynamic decision making by switching between various ACLS algorithms, 3) create a thoughtful approach for further management of refractory ventricular tachycardia, 4) interpret electrocardiogram (ECG) with ST-segment elevation (STE) and left bundle branch block (LBBB), 5) appropriately disposition the patient and provide care after return of spontaneous circulation (ROSC), 6) navigate a difficult conversation with the patient’s husband when she reveals that the patient’s wishes were to not be resuscitated.
Cardiology/VascularSimulation

Managing STEMIs without a Catheterization Lab: A Simulated Scenario to Improve Emergency Clinician Recognition and Execution of Thrombolysis in the Setting of Rural STEMI Management

Scott Schoenborn, MD,*^ Anthony F Steratore, MD,*^ Adam Hoffman, CHSE,*^ Thomas C Marshall, MD,*^ Erica B Shaver, MD,*^ and Christopher S Kiefer, MD*^

DOI: https://doi.org/10.21980/J8K933 Issue 9:2[mrp_rating_result]
By the end of this simulation, learners will be able to: 1) diagnose ST elevation myocardial infarction accurately and initiate thrombolysis in the rural setting without timely access to cardiac catheterization; 2) engage the simulated patient in a shared decision-making conversation, clearly outlying the benefits and risks of thrombolysis; 3) identify the indications and contraindications for thrombolysis in ST elevation myocardial infarction; 4) arrange for transfer to a tertiary care center following completion of thrombolysis.
Cardiology/VascularSimulation