Issue 4:3

Tricyclic Antidepressant Overdose

Patrick G Meloy, MD^*, Amit Bhambri, MD^{^} and Megan C Henn, MD^*

DOI: https://doi.org/10.21980/J85W50Issue 4:3 No ratings yet.

At the end of this oral boards session, learners will be able to: 1) discuss the appropriate laboratory testing and workup for a patient with undifferentiated altered mental status, 2) discuss the importance of obtaining an ECG in a timely manner in order to investigate the broad differential of altered mental status, 3) identify the classic ECG findings of a patient with TCA overdose, 4) review the treatment of TCA overdose, 5) discuss the appropriate disposition of a patient with TCA overdose.

Toxicology Oral Boards

Thyroid Storm

Natalie Ferretti, MD^* and Jennifer Yee, DO^*

DOI: https://doi.org/10.21980/J8XD03Issue 4:3 No ratings yet.

By the end of this simulation session, the learner will be able to: 1) understand the essential physical exam components necessary to evaluate for etiologies of acute encephalopathy, 2) review laboratory and imaging studies to obtain for evaluation of acute encephalopathy and/or suspected thyroid storm, as well as the rationale behind ordering each study, 3) identify underlying etiologies or pathologies for developing thyroid storm, 4) discuss treatment for thyroid storm.

Endocrine Simulation

A Simulated Scenario to Improve Communication Skills of Residents Providing Online Medical Command of Emergency Medical Service Providers

Anthony Steratore, MD^*, Erica B Shaver, MD^*, Melinda J Sharon, MPH^*, Adam Hoffman, MCCP^{^}, Peter S Martin, MD^* and Christopher S Kiefer, MD^*

DOI: https://doi.org/10.21980/J8SK8MIssue 4:3 No ratings yet.

By the end of this simulation, learners will be able to: 1) discuss appropriate medical command instructions for pediatric cardiac arrest; 2) describe alternative methods to obtain weight-based dosing of pediatric critical care medications, if Broselow tape is unavailable; 3) identify need for a definitive airway in a pulseless patient without interruption of chest compressions. Identify need for rapid intraosseous access in a pulseless pediatric patient; 4) describe the indications for helicopter transfer in a critically ill child.

EMS Simulation

Post-Termination Hemorrhage

Nichole Niknafs, DO^* and Alisa Wray, MD^{^}

DOI: https://doi.org/10.21980/J8NW6Q Issue 4:3 No ratings yet.

By the end of this simulation, participants will be able to: 1) recognize post-termination hemorrhage and hemorrhagic shock; 2) demonstrate appropriate acute resuscitation for a patient with hemorrhagic shock; 3) review the differential diagnosis for a patient with post-termination hemorrhage; 4) identify the indications for massive transfusion protocol.

Ob/Gyn Simulation

Thyroid Storm in the Emergency Department

Christopher Eric McCoy, MD, MPH^* and Reid Honda, MD^*

DOI: https://doi.org/10.21980/J8234RIssue 4:3 No ratings yet.

By the end of this simulation-based session, the learner will be able to: 1) Recognize the signs and symptoms of thyroid storm and appropriately diagnose a patient with thyroid storm. 2) Choose appropriate medications for the treatment of thyroid storm. 3) Determine the appropriate disposition for a patient presenting in thyroid storm. 4) Discuss the rationale behind each drug used to treat thyroid storm. 5) List at least three precipitants of thyroid storm.

Endocrine Simulation

A Story About Mesenteric Ischemia

Annahieta Kalantari, DO^*

DOI: https://doi.org/10.21980/J8J33Q Issue 4:3 No ratings yet.

We aim to teach the presentation and management of cardiovascular emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.

Abdominal/Gastroenterology Cardiology/Vascular Small Group Learning

Emergency Medicine Curriculum Utilizing the Flipped Classroom Method: Infectious Disease and Immunology

Benjamin Ostro, MD^*, Andrew King, MD^*, Laura Branditz, MD^*, Daniel R Martin, MD, MBA^*, Daniel Bachmann, MD^*, Ashish Panchal, MD, PhD^* and Michael Barrie, MD^*

DOI: https://doi.org/10.21980/J8DD1T Issue 4:3 No ratings yet.

We aim to teach the presentation and management of infectious disease and immunological emergencies through the creation of a flipped classroom design. The topics include sepsis, sexually transmitted infections (STIs), tropical diseases, angioedema and anaphylaxis, transplant-related emergencies, and collagen vascular diseases. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. The goal of our curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.

Infectious Disease Curriculum

Point-Of-Care Ultrasound for the Diagnosis of Extensor Tenosynovitis

James A Frank, MD^*, Joshua Lupton, MD^* and Bryson Hicks, MD^*

DOI: https://doi.org/10.21980/J8Q050Issue 4:3 No ratings yet.

Point-of-care ultrasound of the dorsal aspect of the left hand reveals a heterogenous hypoechoic fluid collection surrounding the extensor tendons (axial view) within the retinaculum consistent with edema. Longitudinal view shows anechoic fluid within the tenosynovium which is located between the anisotropic extensor tendon and linear hyperechoic synovial sheath. Longitudinal view also shows some cobblestoning, or tissue edema, superficial to the anisotropic extensor tendon. The patient’s contralateral right dorsal hand was scanned in a longitudinal view and shows no cobblestoning or hypoechoic fluid under the synovial sheath. The patient was diagnosed with tenosynovitis, and started on intravenous antibiotics.

Orthopedics Infectious Disease Ultrasound Visual EM

Point-of-care Ultrasound in the Diagnosis and Monitoring of Bladder Hematoma vs. Hemorrhage

Esther Kim, BS^* and Shadi Lahham, MD, MS^*

DOI: https://doi.org/10.21980/J8092FIssue 4:3 No ratings yet.

Bladder POCUS demonstrated 500mL of post void residual fluid, indicative of retention. Half of the volume is hyperechoic (red circle); this is likely the bladder wall hematoma. Could also consider sonographic artifact, bladder mass, or cystitis.1-2

Genitourinary Ultrasound Visual EM

Asymptomatic CT Iodinated Contrast Extravasation of the Upper Extremity

Eric Liao, MD^* and John Costumbrado, MD, MPH^*

DOI: https://doi.org/10.21980/J8VK87 Issue 4:3 No ratings yet.

The two radiographs demonstrate extravasation of radiopaque iodinated contrast in the lower left upper extremity with most seen in the left antecubital fossa and left proximal forearm. Extravasation is seen in the subcutaneous and subfascial tissue.

Visual EM Orthopedics