Issue 6:3

Implementation of a Medical Education Rotation for Senior Emergency Medicine Residents

Deena Ibrahim Bengiamin, MD^*, Lizveth Fierro, MD^*, Molly Estes, MD^*, Michael Kiemeney, MD^* and Timothy Patrick Young, MD^*

DOI: https://doi.org/10.21980/J8BH17 Issue 6:3 No ratings yet.

Our objectives were to provide our senior residents with exposure to various aspects of the field of MedEd, to further develop their teaching skills and to encourage them to consider a career in academic emergency medicine.

Curriculum Administration

A Novel Virtual Emergency Medicine Residents-as-Teachers (RAT) Curriculum

Shannon Marie Burke, MD^*, Thaddeus Schmitt, MD^*, Corlin Jewell, MD^* and Benjamin Holden Schnapp, MD, MEd^*

DOI: https://doi.org/10.21980/J86S71 Issue 6:3 No ratings yet.

The goals of this curriculum are to provide residents with an introduction to teaching techniques that can be utilized on-shift to facilitate an excellent educational experience for junior learners while balancing the resident’s patient care responsibilities.

Administration Curricula

Pediatric Simulation-Based Prehospital Training Course in Botswana

Nicolaus W Glomb, MD, MPH^*, Marideth C Rus, MD^{^}, Adeola Adekunbi Kosoko, MD^‡, Sharmistha Saha, MD^**, Kristen Murphy, MD^{^}, Cara B Doughty, MD^{^}, Cafen Galapi, RN^{^^}, Bushe Laba, EMT-P^{^^}, and Manish I Shah, MD^{^}

DOI: https://doi.org/10.21980/J8306S Issue 6:3 No ratings yet.

The objective of this educational project was to design, implement, and evaluate a curriculum relevant to an EMS system based in a LMIC, so that it could be a basis for curricula for use in similar contexts. The educational goal is to improve prehospital providers performance in common pediatric resuscitations.

Curricula Pediatrics Simulation

Modified Manikin for Tracheoinnominate Artery Fistula

Emily M Tarver, MD^*, Gina D Jefferson, MD, MPH^{^}, Patrick Parker^‡, Kristina Readman^‡, Susana M Salazar Marocho, BDS, PhD^** and Anna A Lerant, MD, CHSE^‡^{^^}

DOI: https://doi.org/10.21980/J8Z93H Issue 6:3 No ratings yet.

By the end of this educational session, learners will be able to: 1) perform a focused history and physical exam on any patient who presents with bleeding from the tracheostomy site; 2) describe the differential diagnosis of bleeding from a tracheostomy site, including a TIAF; 3) demonstrate the stepwise management of bleeding from a suspected TIAF, including cuff hyperinflation and the Utley Maneuver; 4) verify that definitive airway control via endotracheal intubation is only feasible in the tracheostomy patient when it is clear, upon history and exam, that the patient can be intubated from above; and 5) demonstrate additional critical actions in the management of a patient with a TIAF, including early consultation with otolaryngology and cardiothoracic surgery as well as emergent blood transfusion and activation of a massive transfusion protocol.

Innovations Procedures Respiratory

Meningococcal Meningitis with Waterhouse-Friderichsen Syndrome

Jonathan Kelley, DO^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8TH1K Issue 6:3 No ratings yet.

By the end of this simulation session, learners will be able to: (1) manage a patient with altered mental status (AMS) with fever while maintaining a broad differential diagnosis, (2) recognize the risk factors for meningococcal meningitis, (3) manage a patient with worsening shock and perform appropriate resuscitation, (4) develop a differential diagnosis for thrombocytopenia and elevated international normalized ratio (INR) in an altered febrile hypotensive patient with rash, (5) manage the bleeding complications from WFS, (6) discuss the complications of meningococcal meningitis including WFS, and (7) review when meningitis prophylaxis is given.

Infectious Disease Neurology Simulation

Eclampsia

Thomas J Yang, MD^*, Rohit B Sangal, MD, MBA^* and Lauren W Conlon, MD^{^}

DOI: https://doi.org/10.21980/J8PS8R Issue 6:3 No ratings yet.

By the end of this simulation session, learners will be able to: 1) demonstrate care of a gravid patient with altered mental status; 2) demonstrate care of a gravid patient with seizures; 3) recognize care involved in assessment of fetal status; 4) execute appropriate subspecialty consultation; 5) recognize the clinical signs and symptoms of eclampsia; 6) distinguish different treatment options for eclampsia; 7) identify magnesium toxicity and reversal agent; and 8) differentiate the spectrum of preeclampsia.

Ob/Gyn Simulation

Tracheoinnominate Artery Fistula

Emily M Tarver, MD^*, Anna A Lerant, MD, CHSE^{^}, Jeffrey D Orledge, MD^*, Benjamin P Stevens, MD^‡, and Gina D Jefferson, MD, MPH, FACS^‡

DOI: https://doi.org/10.21980/J8K05R Issue 6:3 No ratings yet.

By the end of this simulation, learners will be able to: 1) perform a focused history and physical exam on any patient who presents with bleeding from the tracheostomy site, 2) describe the differential diagnosis of bleeding from a tracheostomy site, including a TIAF, 3) demonstrate the stepwise management of bleeding from a suspected TIAF, including cuff hyperinflation and the Utley Maneuver, 4) verify that definitive airway control via endotracheal intubation is only feasible in the tracheostomy patient when it is clear, upon history and exam, that the patient can be intubated from above, 5) demonstrate additional critical actions in the management of a patient with a TIAF, including early consultation with otolaryngology and cardiothoracic surgery as well as emergent blood transfusion and activation of a massive transfusion protocol.

Procedures Respiratory Simulation

A Case Report of Glycogenic Hepatopathy

Dane Brown, MD^* and Theresa Mead, DO, RDMS^*

DOI: https://doi.org/10.21980/J8SQ0Z Issue 6:3 No ratings yet.

The ultrasound images reveal hepatomegaly and an increased echogenicity of the liver parenchyma that is diffuse. The increased echogenicity can be best appreciated by a comparison to surrounding structures. It is important to note that the increased echogenicity is non-focal and consistent throughout the entire liver in multiple views. These findings can be consistent with nonalcoholic steatohepatitis as well as glycogenic hepatopathy.

Endocrine Visual EM

A Case Report of a Large Goiter Resulting in Tracheal Deviation

Thomas Powell, MD^* and Geremiha Emerson, MD^*

DOI: https://doi.org/10.21980/J80645 Issue 6:3 No ratings yet.

In the image, one can see significant tracheal deviation around the right side of the mass (black arrows). This degree of deviation would make ventilation in a paralyzed patient extremely difficult, if not impossible.

Endocrine Visual EM

Case Report—Pediatric Brugada Phenotype from Accident Cocaine Ingestion

Patrick Bruss, MD^*, Sarah Norris, DO^*, Kaylene Pagan, MD^*, Richard Cousino, DO^*, Allison Grim^*, and Gregory Reinhold, DO^*

DOI: https://doi.org/10.21980/J8VH28 Issue 6:3 No ratings yet.

Initial EKG was concerning for type I Brugada pattern with an incomplete right bundle branch block in V1 & ST segment elevation terminating in an inverted T wave in V2. There are also signs of sodium channel toxicity with a widened QRS complex, tachycardia and a terminal R wave present in aVR where the R wave is bigger than the S wave or the R wave is over 3mm in aVR.

Cardiology/Vascular Visual EM