Journal of education & teaching in emergency medicine最新文献

{"title":"Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation.","authors":"Matthew Heffernan, Jennifer Quinn, Craig Tschautscher, Ryan Newberry, Andrew Cathers, Brittney Bernardoni","doi":"10.21980/J82354","DOIUrl":"https://doi.org/10.21980/J82354","url":null,"abstract":"<p><strong>Audience: </strong>This simulation is designed for critical care transport providers but can be easily adapted for the inpatient setting. It is applicable to an interdisciplinary team including nurses, respiratory therapists, medical students, emergency medicine residents, and emergency medicine attendings.</p><p><strong>Introduction: </strong>Cardiogenic shock carries an incredibly high burden of morbidity and mortality. Acute myocardial infarction accounts for 81% of cardiogenic shock patients and is a common indication for transfer to a tertiary care facility.1 Hypotension due to cardiogenic shock is often refractory to volume resuscitation and often requires pharmacologic intervention. Additionally, the resultant end organ dysfunction frequently requires advanced ventilatory support.1-6 This simulation aims to educate critical care transport providers on the best practices for management of the cardiogenic shock patients requiring resuscitation and intubation prior to transport.</p><p><strong>Educational objectives: </strong>By the end of this simulation session, learners will be able to: 1) recognize the need for intubation in an unstable patient in cardiogenic shock who requires transport, 2) appropriately titrate bi-Level non-invasive ventilatory support (BiPAP) to optimize oxygenation and ventilation in preparation for intubation, 3) choose appropriate vasoactive medications to support the hemodynamics of a patient in cardiogenic shock, 4) perform rapid sequence intubation using appropriate induction and paralytic agents and dosing for a patient in cardiogenic shock, 5) choose appropriate initial lung-protective ventilator settings, and 6) implement an adequate analgesia and sedation plan for transport of an intubated patient in cardiogenic shock.</p><p><strong>Educational methods: </strong>This session was conducted using high-fidelity simulation, allowing learners to manage a patient in cardiogenic shock and respiratory distress requiring intubation. Each session was followed by a debriefing and discussion.</p><p><strong>Research methods: </strong>Qualitative feedback provided by participants during the discussion session was utilized to adjust the simulation between each session. In addition, participants were surveyed using a five-point Likert scale (strongly disagree to strongly agree) on if the simulation met their professional and educational needs, its efficacy and appropriateness for Level, and whether it would change future practice.</p><p><strong>Results: </strong>A total of 36 learners, including 20 physicians and 16 nurses, participated in the simulation over a total of nine sessions. Twenty out of the thirty-six participants completed the survey (both RNs and MDs) and 100% responded \"strongly agree\" to all four prompts (top response out of a five Likert scale). Feedback provided by participants was used after each session to adjust the simulation. Changes implemented included the addition of a nurse confederate, g","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"S31-S57"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My Broken Heart.","authors":"Kelly N Roszczynialski, Alana E Harp, Cameron A Fisk, Kristen M Ng, Ashley C Rider","doi":"10.21980/J85W7R","DOIUrl":"https://doi.org/10.21980/J85W7R","url":null,"abstract":"<p><strong>Audience: </strong>The target audience for the key learning objectives of this Left-Ventricular Assist Device (LVAD) simulation are emergency medicine residents. Other team members such as attendings, nurses, pharmacists, and technicians could potentially be integrated.</p><p><strong>Introduction: </strong>Left ventricular assist devices (LVADs) are common bridge therapy for patients suffering from severe heart failure to cardiac transplant or destination therapy for non-transplant candidates.1 Emergency medicine physicians must be prepared for a variety of device complications that may result in an acute care presentation, such as drive-line infections, suction events, arrhythmias, and cardiac arrest with device failure. In a review investigating ED presentations for patients with LVADs, device-specific complaints were among the fewest, with the most common presentations involving bleeding, infection, and arrythmias.2 The present case involves a suction event that is precipitated by a gastrointestinal (GI) bleed, which has an incidence of 30% for LVAD patients.3 This case was developed for a technology failure-themed resident simulation competition during the Western Society for Academic Emergency Medicine (SEAM) conference held on April 1, 2022.</p><p><strong>Educational objectives: </strong>By the end of this simulation session, learners will be able to: 1) assess the hemodynamics of an LVAD patient by using a Doppler to determine mean arterial pressure, 2) Manage an arrhythmia in an LVAD patient with a suction event by addressing preload, 3) Identify and treat the source of hypovolemia (a massive lower gastrointestinal hemorrhage), 4) Perform clear closed-loop communication with other team members.</p><p><strong>Educational methods: </strong>This high-fidelity simulation case aims to train emergency medicine residents on recognition and management of an LVAD suction event, a rare but serious presentation encountered in the emergency department. This simulation can be successfully implemented either <i>in situ</i>, in an immersive simulation center, or off-site. This case could be represented by lower fidelity mannequins without the capabilities to provide learner tactile feedback of hemodynamics or airway, with a separate monitor device such as SimMon to display vital signs and digital media to demonstrate needed clinical images. The audio file of the low-flow alarm can be accessed and played by any device with internet access. The simulation benefits from embedded simulation participants to act as the bedside nurse and wife to provide history. This simulation included debriefing focused on a critical action checklist.</p><p><strong>Research methods: </strong>A working group of two simulation-trained faculty, a simulation fellow, and three senior emergency medicine residents chose and developed the simulation case. Two simulation-trained faculty implemented the pilot case series to gather feedback on performance against the critica","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"S1-S30"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Ultrasound-Guided Erector Spinae Plane Nerve Block Model for Training Emergency Medicine Physicians.","authors":"Jose Correa Ibarra, Amelia Crowley, Sydney Hughes Lindros, Kevin B Walker, Caroline Astemborski, Phillip Moschella","doi":"10.21980/J8PW7D","DOIUrl":"https://doi.org/10.21980/J8PW7D","url":null,"abstract":"<p><strong>Audience: </strong>This ultrasound-guided erector spinae plane (ESP) nerve block model is designed to instruct emergency medicine (EM) attending and resident physicians. However, this innovation is appropriate for all levels of learners, including medical students, advanced practice clinicians (APCs), and clinicians in other medical specialties.</p><p><strong>Introduction: </strong>The ESP nerve block is a relatively new regional anesthesia technique that involves injection of local anesthetic along the fascial plane below the erector spinae muscles.1-3 The ESP nerve block was first described in 2016 by Forero et al. to help manage severe thoracic neuropathic pain resulting from malunion of multiple rib fractures and metastatic disease of the ribs.1 The block has since emerged as a safe, feasible and effective analgesic intervention for various pathologies, including management of pain for acute rib fractures.2,3 However, barriers to implementation into routine practice in the emergency department (ED) exist due to gaps in knowledge about the block and a lack of training.4 We created a novel, inexpensive, and portable ultrasound-guided ESP nerve block model that can be used to facilitate training for EM physicians and residents.</p><p><strong>Educational objectives: </strong>This innovation model is designed to facilitate hands-on training of the ultrasound-guided ESP nerve block using a practical, realistic, and cost-effective ballistics gel model. By the end of this training session, learners should be able to: 1) identify relevant sonoanatomy on the created simulation model; 2) demonstrate proper in-plane technique; and 3) successfully replicate the procedure on a different target on the created training model.</p><p><strong>Educational methods: </strong>We created a cost-effective ESP nerve block model using a 3-D printed spine and ribcage suspended in ballistics gel that is compatible with ultrasound. The use of ballistics gelatin in the model closely simulates the viscosity and density of animal tissue, allows for ultrasound use, and is cost-efficient and more feasible than other organic models because it can be easily melted and re-used.5 At the time of this model's creation, the only previous approach to creating an ESP model was a porcine model that used meat cuts from the lower thoracic region and spine. However, the major limitation of this porcine model was its limited shelf life.6 The created ESP model was incorporated into a hands-on training module that took place one to two times per week over two months. Additional sessions were incorporated on a case-by-case basis. All participants were first given access to an educational ESP Nerve Block PowerPoint presentation to be reviewed prior to attending in-person sessions. The training sessions were promoted through weekly email reminders containing the dates and a link to an online sign-up sheet. Additionally, on training days, our project director actively sought to recruit","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"I1-I10"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Silent Saboteur: Teaching the Clinical Implications of Occult Hypoxemia & Social Determinants of Health via a Pulmonary Embolism Case.","authors":"Eugene Marrone, John Cafaro, Jared Klein","doi":"10.21980/J8FD14","DOIUrl":"https://doi.org/10.21980/J8FD14","url":null,"abstract":"<p><strong>Audience: </strong>Medical students on required fourth-year emergency medicine clerkship.</p><p><strong>Introduction: </strong>Social determinants of health are the nonmedical factors that influence health outcomes.1 As part of the AMA Accelerating Change in Medical Education Consortium's third pillar of medical education, health systems science, social determinants of health are recognized as critical components to medical student education.2 The push for institutions to address health inequities has led medical schools to emphasize social determinants of health.3 Medical students have stepped up to advocate for change and are demanding concrete action, including the development of antiracist curriculum and learning environments.4 The current and next generations of physicians need to be prepared to be responsive to the public health and societal needs of everyone.5 Emergency departments are a window into a community and its challenges, reflecting the most critical social determinants of health (SDH) of the population they serve; as such, they are the ideal setting in which to learn about SDH.6 Core emergency medicine (EM) clerkships typically focus on disease management for the acutely ill and injured, with limited emphasis on the holistic care that addresses a patient's SDH-a missed educational opportunity.7 We present an oral (or white) board case that highlights the basic approach to pulmonary embolism while emphasizing consideration of both social determinants of health and racial considerations.</p><p><strong>Educational objectives: </strong>By the end of this oral board case, learners will be able to: 1) obtain appropriate history of present illness (HPI) and physical exam elements for the undifferentiated chest pain patient, 2) identify elements of history and physical exam that are compatible with pulmonary embolism, 3) formulate a differential diagnosis for chest pain and perform the appropriate work-up to narrow this differential diagnosis, 4) appropriately manage pulmonary embolism, 5) review and discuss the diversity, equity and inclusion (DEI) elements of the case, and 6) review and discuss the importance of social determinants of health (SDH) in disposition decisions and patient outcomes.</p><p><strong>Educational methods: </strong>This case is meant to be used as an oral board or white board case for medical students and interns.</p><p><strong>Research methods: </strong>Educational content was assessed via three questions related to occult hypoxemia and Glomerular Filtration Rate (GFR) reporting by race at the end of clerkship exam. The results of learners who were present for the case were compared to those who were not present. Results were stratified to compare whether the student was applying for an Emergency Medicine residency or another specialty.</p><p><strong>Results: </strong>A total of 72 students completed the end of clerkship exam, with three questions related to diversity, equity, and inclusion. Data was s","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"O1-O29"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Inferior Rectus Abscess.","authors":"Luke Chi, Adam Sauer, Danielle Matonis","doi":"10.21980/J8J35G","DOIUrl":"https://doi.org/10.21980/J8J35G","url":null,"abstract":"<p><p>Soft tissue infections, including abscesses, are frequently encountered in the emergency department. However, abscesses of the inferior rectus muscle are rare and may present unique diagnostic and therapeutic challenges due to the scarcity of documented cases. This case report highlights the treatment of a 47-year-old male presenting with an abscess in the left inferior rectus muscle due to an acute Methicillin-resistant Staphylococcus aureus infection. Imaging revealed a distinct fluid collection compressing the left globe, causing restricted ocular motility and other symptoms. Despite prior intravenous antibiotics, the abscess persisted. While intravenous antibiotics are an important component of treatment, this case highlights the potential insufficiency of this approach alone, emphasizing a need for surgical intervention such as orbitotomy for drainage. This report contributes to the limited literature on inferior rectus muscle abscesses and underscores the need for further research and clinical attention to optimize patient outcomes.</p><p><strong>Topics: </strong>Abscess, soft tissue infection, extraocular muscles, pyomyositis, Methicillin-resistant Staphylococcus aureus, proptosis, diplopia, vision loss.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V10-V13"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis and Necrotizing Soft Tissue Infection.","authors":"Matthew Henschel, Stephanie Songey","doi":"10.21980/J89M0K","DOIUrl":"https://doi.org/10.21980/J89M0K","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Emergency medicine (EM) residents at all levels of education and medical students on EM rotation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Diabetes is a chronic disease diagnosed in over 28 million people in the United States which causes serious acute complications and is responsible for more than two million ED visits per year.1,2 Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes; it is diagnosed with the triad of hyperglycemia, anion gap metabolic acidosis, and ketonemia. The most common cause of DKA is infection, but it can also be precipitated by medication noncompliance, cerebral vascular accident or transient ischemic attack, myocardial infarction, acute pancreatitis, new onset diabetes, and medication side effect, among other causes. Our case involves a patient in DKA that was precipitated by a severe life- and-limb-threatening, necrotizing, soft tissue infection (NSTI). Management includes prompt recognition, antimicrobial therapy, and surgical debridement.3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;At the end of this oral board session, examinees will: 1) Demonstrate the ability to obtain a complete medical history and physical exam. 2) Identify and appropriately treat DKA. 3) Identify, treat, and make appropriate consults for NSTI. 4) Demonstrate effective communication of the treatment plan with the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This is an oral board case following a standard American Board of Emergency Medicine-style case in a tertiary care hospital with access to all specialists and resources needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;This case was tested using 12 resident volunteers ranging from PGY 1 - 2 in an ACGME (Accreditation Council for Graduate Medical Education) accredited emergency medicine program in a virtual video conference setting. Practice candidates were seven PGY1 and five PGY2 level residents. Scoring measures of the ACGME core competencies were performed by program core faculty using a scale from 1 - 8 using the American Board of Emergency Medicine (ABEM) oral boards standard case rating. A debriefing session followed the case to discuss the critical actions and for the residents to rate their experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average score for practice candidates per level was: PGY1: 4.4, PGY2: 5.7. Average critical action missed per level was: PGY1: 3.3, PGY2: 0.2. All candidates recognized the patient was in DKA, with varied confidence and comfortability in the appropriate potassium and insulin dosing. On average, practice candidates rated the case as 4.81 (1 - 5 Likert scale, 5 being that the case increased their medical knowledge). No significant modifications were made to the case following the practice session.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The aim of this case was to identify and treat two life-threatening diagnoses experienced by patients with diabetes, DKA and NSTI. There are many causes of DK","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"O30-O56"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of an Unstable C-spine Fracture in the Emergency Department.","authors":"Jinho Jung, Tyler Rigdon, Alisa Wray, Danielle Matonis","doi":"10.21980/J8SK90","DOIUrl":"https://doi.org/10.21980/J8SK90","url":null,"abstract":"<p><p>Unstable cervical spine (c-spine) fractures are of high concern in traumatic incidents because they may result in significant morbidity and mortality. This is a case of a 44-year-old male who presents to the Emergency Department (ED) with neck pain after recreational wrestling and was found to have an unstable C-spine fracture. His treatment course was complicated by multiple interrupted hospital stays due to leaving against medical advice (AMA) and subsequent returns to the emergency department. The patient received both CT and MRI imaging and ultimately underwent occiput to C3 fusion with drain placement with a favorable outcome. This case report highlights the diagnosis and treatment of a patient with an unstable c-spine fracture. Key lessons from the case include the importance of timely recognition of patients with a potential c-spine fracture and identifying those who are at risk for nonadherence to medical treatment plans in order to provide interventions and improve chances of adherence. For patients in which pre-hospital care is involved, such as emergency medical services (EMS), recognition and appropriate care, such as c-spine stabilization, may be important for long-term outcomes.</p><p><strong>Topics: </strong>Unstable c-spine fracture, polysubstance use, spinal injury, neck trauma.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V1-V5"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Hydropic Gallbladder Presenting as Right Lower Quadrant Abdominal Pain.","authors":"Savannah Tan, Zoe Adams, Scott Rudkin, Danielle Matonis","doi":"10.21980/J8DD26","DOIUrl":"https://doi.org/10.21980/J8DD26","url":null,"abstract":"<p><p>An 18-year-old female presented to the emergency department (ED) with two days of right lower quadrant pain and associated nausea and emesis. After relevant information was gathered and with physical exam findings of a tender right lower quadrant, positive psoas sign, positive Rovsing sign, and pain with right heel tap, the patient was presumed to have appendicitis. However, imaging contradicted the initial leading diagnosis and revealed a markedly distended, hydropic gallbladder with its tip near the umbilicus. Findings of the distended gallbladder with marked wall thickening and pericholecystic fat stranding and edema confirmed acute cholecystitis, and the patient was taken by general surgery for cholecystectomy. Together, this unusual presentation and this unexpected diagnosis shine light upon another facet of the hydropic gallbladder while also serving as a salient reminder to contemplate a broad differential regardless of seemingly classic presentations of illnesses.</p><p><strong>Topics: </strong>Cholecystitis, hydropic gallbladder, abdominal pain, appendicitis.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V14-V16"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Surgery Didactic Session Improves Confidence in Distal Radius Fracture Management by Emergency Medicine Residents.","authors":"Ian T Watkins, Jessica L Duggan, Aron Lechtig, Andrew Bauder, Luke He, Alexy Ilchuk, Amanda Doodlesack, Carl Harper, Tamara D Rozental","doi":"10.21980/J8K365","DOIUrl":"https://doi.org/10.21980/J8K365","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This didactic session on distal radius fracture diagnosis and management is designed for Emergency Medicine (EM) residents of all levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;With an incidence of 1,130 upper extremity injuries per 100,000 persons per year,1 distal radius fractures (DRFs) are the most common adult fracture, representing 17.5% of all fractures.2-4 Yet, many emergency medicine residents feel unprepared to manage DRFs independently upon graduation.5 The standard management of a fracture in the ED setting consists of identifying any urgent aspects of the fracture, controlling pain, performing a reduction if necessary, and applying a splint.6 Poor reduction or splinting techniques can lead to serious complications, including acute carpal tunnel or compartment syndrome, development of severe burns and rarely, amputation.6-8 Though it is common for emergency medicine (EM) resident trainees working in academic institutions to have regular access to orthopaedic surgery consultation, many will go on to practice in community settings or departments without access to full-time orthopaedic coverage. It is essential for EM residents to be familiar with DRF diagnosis and management, including closed reduction and splinting. We seek to create a toolbox for managing upper extremity fractures, with the overall purpose of improving orthopaedic care in the ED setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this didactic session, learners should be able to: 1) assess DRF displacement on pre-reduction radiography and formulate reduction strategies, 2) perform a closed reduction of a DRF, 3) apply a safe and appropriate plaster splint to patient with a DRF and assess the patient's neurovascular status, 4) assess DRF post-reduction radiography for relative fracture alignment, and 5) understand appropriate follow-up and necessary return precautions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;Learners attended a didactic session led by orthopaedic surgery residents which included a faculty-approved lecture on DRFs and hands-on skills workshop on reducing the fractures and effectively applying plaster splints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Prior to the educational session, participants completed a pre-workshop survey assessing current practices and baseline confidence regarding DRF management. Self-confidence levels for each skill were measured using a Likert scale from 0 (least confident) to 100 (most confident). Confidence levels were re-assessed immediately after the didactic session and three months later.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen emergency medicine (EM) residents (n=12, 63% female) across three class years (n=9, 47% PGY 1; n=6, 32% PGY 2; n=4, 21% PGY 3) completed the pre-workshop survey, and 15 residents participated in the didactic session and completed follow-up surveys. Fourteen (75%) EM residents reported reducing DRFs on their own (without an orthopaedic consult) less","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"SG1-SG9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye-Opener: A Case Report of Eyelid Taping as Presenting Symptom of Myasthenia Gravis.","authors":"Mary G McGoldrick, Chirag N Shah","doi":"10.21980/J8NW8G","DOIUrl":"https://doi.org/10.21980/J8NW8G","url":null,"abstract":"<p><p>Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction that can cause various symptoms provoking a visit to the emergency department (ED). In this case, we present a 54-year-old female who reported having her eyes \"taped open\" for the last two months. Her history and physical exam findings in the ED raised suspicion for MG. The patient was subsequently admitted and started on pyridostigmine. An elevated acetylcholinesterase receptor-binding antibody level confirmed the diagnosis of MG. This case report highlights the characteristic progressive weakness of facial muscles in MG, emphasizing the importance of early recognition of MG symptoms by emergency clinicians in order to initiate appropriate management and prevent respiratory compromise and morbidity.</p><p><strong>Topics: </strong>Neurology, neurologic exam, myasthenia gravis, emergency medicine.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V6-V9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}