Latest Articles
Bilateral Common Iliac Artery Aneurysm
DOI: https://doi.org/10.21980/J83S73A bedside ultrasound of the aorta was performed. The proximal, middle, and distal aorta appeared normal in caliber, as demonstrated by the images; however there seemed to be some enlargement at the bifurcation. The bifurcation into the iliac arteries, as highlighted by the yellow arrow, demonstrates a slightly enlarged iliac artery on the left. The aorta was followed below the bifurcation as it divided into the iliac arteries, as shown in the video clip. The ultrasound demonstrated a left iliac artery aneurysm measuring 5.99 cm, as highlighted by the orange circle. There were aneurysms to the bilateral common and internal iliac arteries.
Case Report: Acute Supraglottitis
DOI: https://doi.org/10.21980/J8006VOn arrival, radiographs of the neck soft tissues were obtained, which showed a markedly enlarged epiglottic shadow (red arrow) concerning for epiglottitis. A computed tomography scan of the neck soft tissues with contrast was then obtained which revealed edematous mucosal thickening of the oropharynx (blue arrow) and supraglottic larynx (green arrow) including the epiglottis (purple arrow) concerning for acute infectious pharyngitis and supraglottic laryngitis with severe narrowing of the supraglottic laryngeal lumen, as well as associated extensive inflammation and edema of the superficial and deep left neck spaces. The patient’s white blood cell count was elevated to 25.7x109/L with 87% neutrophils. Her rapid strep test was positive. Otolaryngology was consulted and performed a bedside flexible laryngoscopy which showed significant edema of the epiglottis (orange arrow), vocal cords (white arrow), and arytenoids (black arrow), left greater than right. Based on the findings and concern for impending respiratory failure, the patient received an awake fiberoptic intubation by anesthesia at the bedside.
Case Report of the Unusual Presentation of Stridor in an Elderly Patient Following a Cervical Fracture
DOI: https://doi.org/10.21980/J8V926The cervical CT was significant for a transverse fracture through the C4 vertebral body (see red arrow), lateral facet (green arrow), spinous process (blue arrow), and right lamina (purple arrow) as well as surrounding edema and retropharyngeal thickening (yellow line), best appreciated on sagittal view.
A Low-Cost, Reusable Ultrasound Pericardiocentesis Simulation Model
DOI: https://doi.org/10.21980/J8TD1JThrough the use of this model and skill session, learners will be able to: 1) discuss the indications, contraindications, and complications associated with ultrasound guided pericardiocentesis; 2) demonstrate an ability to obtain subxiphoid and parasternal long views of the heart; 3) demonstrate an ability to identify pericardial fluid in these two views; and 4) demonstrate proper probe and needle placement to successfully perform an ultrasound guided pericardiocentesis in these two views.
Henoch-Schönlein Purpura in the Adult
DOI: https://doi.org/10.21980/J8QH08The images show a raised, palpable, purpuric rash on the lower extremities, surrounded by a mild, 1+ non-pitting edema. Several of the lesions are exfoliated with serous discharge. There is no surrounding erythema, fluctuance, or lymphangitis to suggest cellulitis. There was no tenderness to palpation; however, pruritus was exacerbated on palpation.
Digital Nerve Block for the Reduction of a Proximal Phalanx Fracture of the Foot – a Case Report
DOI: https://doi.org/10.21980/J8KS8TPlain film of the right foot showed evidence of an oblique fracture of the body of the proximal 4th phalanx (image 2). No other acute traumatic injuries noted in the rest of the bones and joints of the right foot. After performing a digital block of the toe and reduction, repeat imaging showed evidence of successful reduction with anatomic alignment and redemonstration of the fracture line (image 3).
Case Report: Antifreeze Ingestion and Urine Fluorescence
DOI: https://doi.org/10.21980/J8G05TThe patient’s urine sample (right) was compared to a control (left) using a Wood’s lamp. It revealed light green fluorescence under ultraviolet light, which increased suspicion for ethylene glycol poisoning from antifreeze ingestion.
ECG Stampede
DOI: https://doi.org/10.21980/J8PP93ECG Stampede is a unique educational program comprised of a comprehensive, video-based curriculum with accompanying student and instructor guides. ECG Stampede also features an engaging game accessible via modern browsers and dedicated mobile applications for iOS and Android devices. The gamified model presents learners with a batch of ECGs for which they must assign one of four triage acuities.
Status Asthmaticus
DOI: https://doi.org/10.21980/J8JW6SAt the end of this case, the learners should be able to diagnose an asthma exacerbation, provide the appropriate medications, determine when intubation is necessary, and describe the general principles of ventilator management in an asthmatic patient.
Emergency Medicine Curriculum Utilizing the Flipped Classroom Method: Pulmonary Emergencies
DOI: https://doi.org/10.21980/J8F646The educational strategies used in this curriculum include small group case-based modules authored by education faculty and content experts based on the core emergency medicine content outlined in the ABEM Model EM curriculum. The Socratic method, used during small group sessions, encourages active participation; small groups also focus on the synthesis and application of knowledge through the discussion of clinical experiences. The use of free open access medical education (FOAM) resources allows learners to work at their own pace and maximize autonomy. Learners are encouraged to use such resources for preparation prior to small group sessions, and also to review and help solidify important points after the conclusion of in-person discussions.