Latest Articles

5th Finger Dislocation Photograph JETem 2016
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Open Dislocation of Fifth Digit

Robert Rowe, MD* and Alisa Wray, MD*

DOI: https://doi.org/10.21980/J8J01XIssue 1:2[mrp_rating_result]
Physical exam revealed an open dislocation of the proximal interphalangeal joint (PIP) of the right fifth digit. X-ray confirmed dislocation and revealed no fractures. The patient received a tetanus booster, Cefazolin, and the dislocation was then washed out and reduced. Multiple reduction attempts were made and were only successful once the metacarpophalangeal joints were held in 90 degree flexion, which relaxed the lateral bands and enabled the finger to be reduced.
OrthopedicsVisual EM
Pleural Effusion, AP Chest Xray JETem 2016
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Large Right Pleural Effusion

Robert Rowe, MD* and Alisa Wray, MD*

DOI: https://doi.org/10.21980/J8D59FIssue 1:2[mrp_rating_result]
Chest x-ray and bedside ultrasound revealed a large right pleural effusion, estimated to be greater than two and a half liters in size.
RespiratoryVisual EM
Morel Lavalee Lesion
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Morel-Lavallée Lesion

Grant G Simpson* and Brandon R Allen, MD*

DOI: https://doi.org/10.21980/J88G65Issue 1:2[mrp_rating_result]
On physical examination, the patient was noted to have a nearly “watermelon-sized” fluctuant mass to his right lateral superior quadriceps with multiple overlying abrasions (Image 1). Computed tomography (CT) scans of the area showed a large heterogeneous collection measuring roughly 37x9.5x16 centimeters in the subcutaneous adipose layer of the lateral right thigh (Image 2), while ultrasonography revealed a complex fluid collection containing some nodular solid components and debris (Image 3). Additionally, radiographs confirmed multiple fractures including most significantly a pelvic ring fracture. Surgical debridement, evacuation, and sclerodhesis were performed nine weeks post injury to allow overlying abrasions to heal prior to intervention.
OrthopedicsVisual EM
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A Faculty Development Session or Resident as Teacher Session for Didactic and Clinical Teaching Techniques; Part 1 of 2: Engaging Learners with Effective Didactic Teaching

Megan Boysen-Osborn, MD*, Shannon Toohey, MD*, Michael Gisondi, MD‡, and Margaret Wolff , MD^

DOI: https://doi.org/10.21980/J8RP4TIssue 1:1[mrp_rating_result]
By the end of this workshop, the learner will: 1) describe eight teaching techniques that encourage active learning during didactic sessions; 2) plan a didactic session using at least one of eight new teaching techniques for didactic instruction
Faculty DevelopmentLecturesTeam Based Learning (TBL)
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A Faculty Development Session or Resident as Teacher Session for Clinical and Clinical Teaching Techniques; Part 2 of 2: Engaging Learners with Effective Clinical Teaching

Megan Boysen-Osborn, MD*, Margaret Wolff, MD‡, Michael Gisondi, MD^

DOI: https://doi.org/10.21980/J8MW2WIssue 1:1[mrp_rating_result]
By the end of this workshop, the learner will: 1) describe and implement nine new clinical teaching techniques; 2) implement clinical teaching techniques specific to junior and senior resident learners.
Faculty DevelopmentLecturesTeam Based Learning (TBL)

Carbon Monoxide Poisoning

Alisa Wray, MD*

DOI: https://doi.org/10.21980/J8KH59CIssue 1:1[mrp_rating_result]
By completing this oral board case learners will 1) evaluate a patient with altered mental status and discuss the differential diagnosis of a patient with altered mental status and weakness; 2) recognize the signs and symptoms of carbon monoxide poisoning; 3) manage treatment of a patient with carbon monoxide poisoning
ToxicologyBoard ReviewCertifying Exam Cases
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Emergencies in Hemodialysis Patients

Shannon Toohey, MD*

DOI: https://doi.org/10.21980/J81591Issue 1:1[mrp_rating_result]
By the end of this session, the learner will: 1) describe primary dialysis complications; 2) construct a full differential for a dialysis patient presenting with complications; 3) formulate an appropriate treatment and resuscitation in an acutely ill dialysis patient; 4) plan appropriate disposition and utilization of consultants for dialysis complications.
Renal/ElectrolytesTeam Based Learning (TBL)
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Approach to Acute Headache: A Flipped Classroom Module for Emergency Medicine Trainees

Jeff Riddell, MD*, Stacy Sawtelle, MD^, Paul Jhun, MD‡, James Comes, MD^, Ramin Tabatabai, MD~, Daniel Joseph, MD~, Jan Shoenberger, MD~, Esther Chen, MD‡, Christopher Fee, MD‡, and Stuart Swadron, MD~

DOI: https://doi.org/10.21980/J8WC73Issue 1:1[mrp_rating_result]
At the end of this module, the learner will be able to: 1) list the diagnoses critical to the emergency physician that may present with headache; 2) identify key historical and examination findings that help differentiate primary (benign) from secondary (serious) causes of headache; 3) discuss the indications for diagnostic imaging, lumbar puncture and laboratory testing in patients with headache; 4) recognize life-threatening diagnoses on CT imaging and CSF examination; 5) describe treatment strategies to relieve headache symptoms.
NeurologySmall Group Learning
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Mesenteric Ischemia

Shannon Toohey, MD*

DOI: https://doi.org/10.21980/J8CC7FIssue 1:1[mrp_rating_result]
At the end of this simulation session, the learner will: 1) Recognize signs and symptoms of mesenteric ischemia; 2) order appropriately imaging and labs in the workup of an elderly patient with abdominal pain; 3) manage a patient with mesenteric ischemia, a rare, but serious cause of abdominal pain in the elderly; 4) discuss anchoring bias, specifically related to patients referred to the ED with an established diagnosis by outside specialists.
Abdominal/GastroenterologySimulation
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Atrial Myxoma

Alisa Wray, MD*

DOI: https://doi.org/10.21980/J87P45Issue 1:1[mrp_rating_result]
Bedside ultrasound revealed the presence of a left atrial mass that appeared to be tethered to the mitral valve. The mass was best viewed on ultrasound in the apical four-chamber window with the phased array probe placed over the patients’ point of maximal impact (PMI), with the patient in left lateral decubitus position.
UltrasoundCardiology/VascularVisual EM