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Eclampsia

Patrick G Meloy, MD*, Megan C Henn, MD*, Daniel Rutz, MD^ and Amit Bhambri, MD†

DOI: https://doi.org/10.21980/J8M93D Issue 5:3[mrp_rating_result]
At the end of this oral boards session, examinees will: 1) Demonstrate ability to obtain a complete medical history including a detailed obstetric history. 2) Demonstrate the ability to perform a detailed physical examination in a postpartum female patient who presents with a seizure. 3) Investigate the broad differential diagnoses which include electrolyte imbalances, brain tumor, meningitis or encephalitis, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and eclampsia. 4) List the appropriate laboratory and imaging studies to differentiate eclampsia from other diagnoses (complete blood count, comprehensive metabolic panel, magnesium level, pregnancy testing, urinalysis, and computed tomography [CT] scan of the head). 5) Identify a postpartum eclampsia patient and manage appropriately (administer IV magnesium therapy, administer IV antihypertensive therapy, emergent consultation with an obstetrician). 6) Provide appropriate disposition to the intensive care unit after consulting with an obstetrician.
Ob/GynCertifying Exam Cases
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Low Fidelity Trainer for Fiberoptic Scope Use in the Emergency Department

Garren Giles, DO*, Dominic Diprinzio, DO* and Jordana Haber, MD*

DOI: https://doi.org/10.21980/J8764B Issue 5:3[mrp_rating_result]
By the end of this training session, learners will be able to 1) list indications, contraindication, and complications in performing fiberoptic intubations, 2) know how to use and maneuver a fiberoptic scope, and 3) be able to successfully intubate the trainer model.
ProceduresInnovationsRespiratory
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Periodic Refresher Emails for Emergency Department Mass Casualty Incident Plans

Jessie G Nelson, MD*^, Sara Hevesi, MD†, Robert Welborn, MD†, Krista R Carlson, MD, MS**, Benjamin Eide, MPH^^, Merideth Winkler, RN, BSN†, Marissa K Peterson, MS††, Elizabeth Ramey, MS

DOI: https://doi.org/10.21980/J8C05WIssue 5:3[mrp_rating_result]
This curriculum is intended to maintain a knowledge base of MCI processes to mitigate degradation of necessary knowledge between hands-on MCI training.
EMSAdministrationCurricula
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A Model Curriculum for a Helicopter Emergency Medicine Services (HEMS) Rotation for Resident Physicians

Jordan Imoehl, MD*^, Michael T Steuerwald, MD*^ and Andrew D Cathers, MD*^

DOI: https://doi.org/10.21980/J8GP97 Issue 5:3[mrp_rating_result]
The primary objective of this course is to present a standardized curriculum which allows learners to gain understanding of HEMS systems and retrieval medicine while practicing safety in the aviation environment.
EMSCurricula
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Pediatric Seizure Team-Based Learning

Sara Paradise Dimeo, MD*, Gabriel Sudario, MD^, Supriya Sharma, MD†, Lilly Bellman, MD†, Anjalee Gallion, MD**, Katherine Andreeff, MD^^ and Megan Boysen-Osborn, MD, MHPE^

DOI: https://doi.org/10.21980/J8MD22Issue 5:3[mrp_rating_result]
 By the end of this TBL session, learners should be able to: 1) Define features of simple versus complex febrile seizure, 2) Discuss which patients with seizure may require further diagnostic workup, 3) Summarize a discharge discussion for a patient with simple febrile seizures 4) Identify a differential diagnosis for pediatric patients presenting with seizure, 5) Define features of status epilepticus, 6) Review an algorithm for the pharmacologic management of status epilepticus, 7) Indicate medication dosing and routes of various benzodiazepine treatments, 8) Obtain a thorough history in an infant patient with seizures to recognize hyponatremia due to improperly prepared formula, 9) Choose the appropriate treatment for a patient with a hyponatremic seizure, 10) Describe the anatomy of a ventriculoperitoneal (VP) shunt, 11) Relate a differential diagnosis of VP shunt malfunction, 12) Compare and contrast the neuroimaging options for a patient with a VP shunt
PediatricsNeurologyTeam Based Learning (TBL)
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Build Your Own Eye: A Method for Teaching Ocular Anatomy and Pathophysiology

Alaina Brinley Rajagopal, MD, PhD*, Mark Joseph Slader, BS* and Megan Boysen Osborn, MD, MHPE*

DOI: https://doi.org/10.21980/J8GS8W Issue 5:3[mrp_rating_result]
By the end of this session the participant will be able to: 1) Describe basic anatomy of the eye, 2) Build a basic model of the eye, 3) Identify which diseases are associated with which parts of the eye, 4) Identify the pathophysiology behind diseases of the eye, 5) Name correct treatment for each disease.
OphthalmologyTeam Based Learning (TBL)
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Severe Hyperkalemia

Daniel Johnson, DO* and Dan Wiener, MD*

DOI: https://doi.org/10.21980/J8KH1D Issue 5:3[mrp_rating_result]
The initial ECG obtained upon arrival shows what is commonly referred to as a sine wave pattern. This patient does have a biventricular pacemaker which would ordinarily create a wide QRS complex mimicking an intraventricular conduction delay. However, the QRS complex here is exceptionally wide, in excess of 400 milliseconds (normal: less than 120 milliseconds). As the QRS widens, alongside other deflections present on the ECG, it morphologically mimics a mathematical sine wave.
Cardiology/VascularVisual EM
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Is an X-ray a Useful Test for Esophageal Food Boluses? A Case Report

Meryl M Abrams, MD*, Jennifer L White, MD* and Jeffrey Gardecki, MD*

DOI: https://doi.org/10.21980/J8Q639 Issue 5:3[mrp_rating_result]
The plain film radiograph of the chest demonstrated a fluid level (yellow arrow) in the distal esophagus with dilation of the esophagus proximal to that point (blue line). Neither of these findings were present on the previous visit.
Abdominal/GastroenterologyVisual EM
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Case Report: Talar Neck Fracture

Wilson Frasca, MD* and Nhan Do, MD*

DOI: https://doi.org/10.21980/J8FP75 Issue 5:3[mrp_rating_result]
ABSTRACT: This report demonstrates a case of a severe talar neck fracture. Although rare, talar neck fractures have a high potential for morbidity. Typically caused by a high energy injury, this patient’s mechanism of injury was relatively minor, and presentation was not immediately concerning for such a severe fracture. Initial x-rays provided a gross demonstration of the fracture, but a
OrthopedicsVisual EM
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Case Report of Spontaneous Thyroid Hemorrhage Following LMA Insertion

Gregory Podolej, MD* and Gary Bhagat, MD*

DOI: https://doi.org/10.21980/J8XP8W Issue 5:3[mrp_rating_result]
Two photographs of patients neck, both showcasing no obvious erythema, bruising, or swelling which is noteworthy because there is potential for airway compromise but there was nothing visible to indicate that on exam. CTA of neck showing thyroid nodule and potential thyroid hemorrhage (outlined in orange) on the left without evidence of airway compromise at the time of CT scan. Official read by attending radiologist states there is a “heterogeneous left thyroid nodule measuring 3 cm. Findings are suggestive of multinodular goiter with possible acute hemorrhage. Adjacent tract of soft tissue stranding in the anterior left neck with mild adjacent fascial thickening. This could represent small amount of hemorrhage or could be inflammatory.”
EndocrineVisual EM