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A Realistic, Low-Cost Simulated Automated Chest Compression Device

Jessica Joyce, BS^*, Elyse Fults, MD^{^}, Julia Rajan, BS^†, Alexandra Plezia, MA^**, Carolyn Clayton, MD^{^} and Sara M Hock, MD^{^}

DOI: https://doi.org/10.21980/J8M63C Issue 9:2 No ratings yet.

By the end of this educational session using a resuscitation trainer or high-fidelity manikin, learners should be able to: 1) recognize appropriate application of simulated ACCD to an ongoing resuscitation case; 2) demonstrate proper positioning of simulated ACCD in manikin model and 3) integrate simulated ACCD to provide compressions appropriately throughout cardiac arrest scenario.

Electrical Storm/Refractory Ventricular Tachycardia

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

DOI: https://doi.org/10.21980/J8TS80 Issue 9:2 No ratings yet.

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/Vascular Simulation

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 No ratings yet.

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/Vascular Simulation

Hypertensive Emergency Team-Based Learning

Khoa Nguyen, MD^*, Jordan Gawon Shin^{^}, and Jessica Andrusaitis, MD, MS^*

DOI: https://doi.org/10.21980/J8BP90 Issue 9:2 No ratings yet.

By the end of this TBL session, learners should be able to: 1) define features of asymptomatic hypertension versus hypertensive emergency, 2) discuss which patients with elevated blood pressure may require further diagnostic workup and intervention, 3) identify a differential diagnosis for patients presenting with elevated blood pressures, 4) recognize the features of different types of end-organ damage, 5) review an algorithm for the pharmacologic management of hypertensive emergencies, 6) indicate dosing and routes of various anti-hypertensive medications, 7) choose the appropriate treatment for a patient who is hypertensive and presenting with flash pulmonary edema, 8) identify an aortic dissection on computed tomography (CT), 9) choose the appropriate treatment for a patient who is hypertensive and presenting with an aortic dissection, 10) identify intracranial hemorrhage on CT, 11) choose the appropriate treatment for a patient who is hypertensive and presenting with an intracranial hemorrhage, and 12) describe the intervention for warfarin reversal.

Cardiology/Vascular Team Based Learning (TBL)

Calcium Channel Blocker Overdose

Jessica G Andrusaitis, MD, MS^* and Alan Givertz, MD^{^}

DOI: https://doi.org/10.21980/J8CQ07Issue 9:1 No ratings yet.

At the end of this oral board session, examinees will: (1) demonstrate ability to evaluate a patient with undifferentiated shock with bradycardia and discuss the differential diagnosis, (2) recognize the signs and symptoms of calcium channel blocker overdose, (3) demonstrate ability to manage treatment of a patient with calcium channel overdose.

Current Issue Cardiology/Vascular Oral Boards Toxicology

Ventricular Tachycardia

Rohit Menon, MD^*, Geremiha Emerson, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8KD2R Issue 8:4 No ratings yet.

At the conclusion of the simulation session, learners will be able to: 1) identify the different etiologies of VT, including structural heart disease, acute ischemia, and acquired or congenital QT syndrome; 2) describe confounding factors of VT, such as electrolyte abnormalities and sympathetic surge; 3) describe how to troubleshoot an unsuccessful synchronized cardioversion, including checking equipment connections, increasing delivered energy, and changing pad placement; 4) compare and contrast treatments of VT based on suspected underlying etiology; 5) describe reasons to activate the cardiac catheterization lab other than occlusive myocardial infarction; and 6) identify appropriate disposition of the patient to the cardiac catheterization lab.

Cardiology/Vascular Simulation

Acute Pulmonary Edema and NSTEMI

Ashley Pilgrim, MD^*

DOI: https://doi.org/10.21980/J8CW67 Issue 8:3 No ratings yet.

At the end of this practice oral boards case, the learner will: 1) recognize unstable vital signs (VS) and intervene to stabilize ventilation and oxygenation, 2) demonstrate the ability to obtain a complete medical history including the important characteristics of chest pain, 3) demonstrate an appropriate exam on a patient, 4) order the appropriate evaluation studies for a patient with complaints of dyspnea, 5) interpret the results of diagnostic evaluation and diagnose Non- ST elevation myocardial infarction (NSTEMI) and pulmonary edema, 6) order appropriate management of pulmonary edema and NSTEMI, and 6) demonstrate effective communication with patient and family members.

Cardiology/Vascular Oral Boards

Construction of Soft Prep Cadaver Pericardiocentesis Training Model and Implementation Among Emergency Medicine Residents

Kathryn Oskar, MD^* and Dana Stearns, MD^{^}

DOI: https://doi.org/10.21980/J87930 Issue 8:2 No ratings yet.

By the end of this session, residents will gain increased procedural competence and confidence with pericardiocentesis. Residents will be able to identify necessary supplies for the procedure, identify relevant surface anatomy and ultrasound views, and successfully aspirate fluid from model effusion.

Cardiology/Vascular Innovations Procedures

Peripartum Cardiomyopathy

Victoria L Morris, MD^*, Carolina Mendoza, MD^*, Gowri S Stevens, MD^*, Jessica L Wilson, MD^*and Adeola A Kosoko, MD^*

DOI: https://doi.org/10.21980/J8ZS9M Issue 8:2 No ratings yet.

By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy.

Cardiology/Vascular Ob/Gyn Simulation

A Case Report of Subtle EKG Abnormalities in Acute Coronary Syndromes Indicative of Type One Myocardial Infarction

Paige Matijasich, BA^*, Patrick Bruss, MD^{^}, Gregory Reinhold, MD^{^} and Zachary Koppelmann, MD^{^}

DOI: https://doi.org/10.21980/J8W06X Issue 8:2 No ratings yet.

The ECG does show multiple subtle abnormalities that in conjunction with his symptoms and risk factors are concerning for ischemia and/or occlusion of the coronary artery vessel. 1) ST depression in aVL. Although slight, the ST segment is below the TP segment or isoelectric point (blue circles). 2) Focal hyper QT waves. The T-waves in II, III, AVF V2, V3, and V4 are hyper acute, namely peaked and tall in relationship to the QRS. These are best displayed in leads II, III, and AVF where the T-waves are taller than the QRS amplitude (vertical blue lines). 3) Straightening off the ST segment. Multiple leads display a straight ST segment namely aVL, III, AVF, and V2 (red lines). Of note, the length of the straight ST segment is greater than 1/4 the amplitude of the QRS (purple lines). 4) Although subtle, these abnormalities are focal in nature.

Visual EM Cardiology/Vascular

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