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High-Pressure Injection Injury to the Hand – A Case Report

Cesar Fortuna, MD*^, Derek Prince, MD†, Daniel Ng, MD^† and John Costumbrado, MD, MPH^†

DOI: https://doi.org/10.21980/J8D64W Issue 7:3 No ratings yet.
Plain radiographs of the left hand and forearm demonstrated extensive subcutaneous emphysema. The air can be seen as lucent striations tracking along the second and third fingers as well as along the dorsum of the hand and wrist. There is also diffuse soft tissue emphysema surrounding the metacarpophalangeal joints. Lab analysis did not show any significant acute abnormalities.
OrthopedicsVisual EM
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Management of Poisoned Patients: Implementing a Blended Toxicology Curriculum for Emergency Medicine Residents

Madeline Dwyer, MD*, Megan Stobart-Gallagher, DO*, Jared Kilpatrick, MD* and Alanna O’Connell, DO^

DOI: https://doi.org/10.21980/J8C937 Issue 7:2 No ratings yet.
The goal of this curriculum is to introduce EM residents to core toxicology concepts and to reinforce toxicology principles through a multimodal approach that leads to increased confidence in the management of poisoned patients on shift.
ToxicologyCurriculum
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Peritonsillar Abscess Simulator: A Low-Cost, High-Fidelity Trainer

Chad R Keller, DO*, Ivanna Nebor, MD*, David Choi, MD, FRCSC*, Kattia Moreno, MD* and Yash J Patil, MD, MPH*

DOI: https://doi.org/10.21980/J85M0B Issue 7:2 No ratings yet.
By the end of this training session, learners will be able to: 1) locate the abscess, 2) perform needle aspiration, and 3) develop dexterity in maneuvering instruments in the small three-dimensional confines of the oral cavity without causing injury to local structures.
ProceduresENTInnovations
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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.
Miscellaneous (stats, etc)Simulation
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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. 
PediatricsSimulationToxicology
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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.
WildernessSimulation
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