Journal of education & teaching in emergency medicine最新文献

{"title":"Metastatic Calcinosis Cutis in the Emergency Department: A Case Report.","authors":"Christian Hernandez-Zegada, Holly Conger, Brian Milman","doi":"10.21980/J87Q00","DOIUrl":"10.21980/J87Q00","url":null,"abstract":"<p><p>Calcinosis cutis is a condition in which calcium-phosphate salt deposits are formed in cutaneous and subcutaneous tissue. A subtype, metastatic calcinosis cutis, can occur in patients with disorders that cause hypercalcemia or hyperphosphatemia such as end stage renal disease. We present a case of a 67-year-old man with end-stage renal disease (ESRD) on dialysis who presented to the emergency department with a draining left elbow wound. On exam, he had irregular, firm nodules palpable in the subcutaneous tissue of both large and small joints. The presence of calcinosis cutis on imaging and lack of other findings suggesting infection led to outpatient wound care treatment. Recognizing the appearance of calcinosis cutis on imaging and conditions that present with calcinosis cutis is important for the emergency physician.</p><p><strong>Topics: </strong>Calcinosis cutis, end-stage renal disease, ESRD, dialysis, subcutaneous calcifications.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V1-V4"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790944","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":"Posterior Reversible Encephalopathy Syndrome and Eclampsia.","authors":"Kristina Jacomino, Kevin Tomecsek, Andrew Little, Mary Mclean","doi":"10.21980/J8H64T","DOIUrl":"10.21980/J8H64T","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Emergency medicine residents, fellows, and recent graduates. Emergency medicine-bound senior medical students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Posterior reversible encephalopathy syndrome (PRES) is an illness in which a person can present with acutely altered mentation, drowsiness or sometimes stupor, visual impairment, seizures (focal or general tonic-clonic), and sudden or constant, non-localized headaches.1 Patients at risk for developing PRES include those with underlying hypertension, preeclampsia, kidney disease, liver disease, exposure to cytotoxic medications or immunosuppressants, autoimmune disorders or sepsis. As a syndrome, PRES has gone underdiagnosed given its broad symptomatology. While it appears to affect people of all ages, it is more commonly found in middle-aged females. The underlying cause for PRES remains unclear, but some proposed mechanisms center on the dysregulation of cerebral autoregulation, the brain's ability to maintain constant cerebral blood flow over a range of blood pressures via the constriction or dilation of the cerebral blood vessels.2 The treatment for PRES includes management of hypertension as well as diagnosing and treating the underlying etiology. This disease process needs to be recognized early by the emergency provider to reduce mortality.Eclampsia and other hypertensive disorders in women affect as many as 10% of all pregnancies worldwide and are responsible for approximately 10% of all maternal deaths in the United States.3 Eclampsia is defined as new onset seizures in a woman with a history of preeclampsia who is between 20 weeks gestation and within four weeks postpartum.4 As an emergency medicine provider, it is imperative to be able to manage and treat a patient with eclampsia to decrease mortality and morbidity of the mother and fetus. Management of eclampsia includes treatment for seizures using magnesium sulfate, treatment for hypertension, and emergent obstetrics consult for possible delivery of the fetus.4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;At the end of this oral boards session, examinees will be able to: 1) demonstrate familiarity with the structured interview oral board format and case play; 2) recognize the history and exam features concerning for PRES and eclampsia; 3) order appropriate diagnostic workup for postpartum and hypertensive emergencies including eclampsia and PRES; 4) understand treatment options for the management of eclampsia (intravenous [IV] magnesium sulfate, IV antihypertensive therapy, and emergent consultation with an obstetrician [OB/GYN]); 5) understand threshold for taking control of airway in patients with eclampsia; 6) understand indications for ordering brain imaging in patients with eclampsia and altered mental status; and 7) demonstrate effective communication with treatment team/family members as well as correct disposition of the patient to a higher level of care (intensive care unit [ICU]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;E","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"O34-O57"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790945","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 Recipe for Disaster - Sodium Bicarbonate Overdose.","authors":"Adeola A Kosoko, Amara Ogoke, Kyle Vogt","doi":"10.21980/J8MW85","DOIUrl":"10.21980/J8MW85","url":null,"abstract":"<p><strong>Audience: </strong>Emergency medicine residents post-graduate years 1-4.</p><p><strong>Introduction: </strong>Sodium bicarbonate is a compound found commonplace in many households and in many products. It lends itself to countless everyday uses including cooking and cleaning. Physicians prescribe sodium bicarbonate regularly both on- and off-label regularly for various ailments.1 Due to the ubiquitous way both emergency physicians and the general public use and are exposed to sodium bicarbonate, we wanted to prepare learners to identify and appropriately manage sodium bicarbonate toxicity.Obtaining a thorough history not just of medications prescribed but of significant ingestions or infusions is critical in diagnosing this toxicity. Furthermore, acute sodium bicarbonate overdose should be considered in a patient who may present with severe metabolic alkalosis.1 This case outlines the common signs and symptoms of a patient with acute sodium bicarbonate toxicity and reviews the management of sodium bicarbonate toxicity.</p><p><strong>Educational objectives: </strong>At the end of this oral board session, learners will be able to: 1) obtain a history which includes medications and other supplements used by the patient, 2) interpret a prolonged QTc, 3) diagnose metabolic alkalosis due to sodium bicarbonate toxicity, and 4) manage sodium bicarbonate toxicity with fluid and electrolyte resuscitation.</p><p><strong>Educational methods: </strong>This case was presented to learners using the typical format for the American Board of Emergency Medicine (ABEM) oral certification examination, a standardized test of emergency medicine knowledge. This educational format allows exploration of the evaluation, workup, and management of the rare case of a patient with sodium bicarbonate toxicity in a safe learning environment.For faculty, this case can act as an assessment of an emergency medicine resident's critical thinking skills as they progress through residency. Oral board testing is a key part of resident learning because it prompts residents to apply their learning in a low-stakes environment, both in preparation for the oral certification examination and for clinical practice.</p><p><strong>Research methods: </strong>Immediately after the learners completed the oral boards case and debriefing, feedback was solicited using Google forms, a free and open-access online tool. The participants' feedback was recorded regarding the educational value of the case, using a Likert scale (1-5), and the form also requested feedback about the case, including what was beneficial, and suggestions for improvement.</p><p><strong>Results: </strong>Twenty-six residents in total participated in this oral boards case and five faculty participated as facilitators. All participating faculty gave verbal feedback. After participating in the case, thirteen residents who completed the feedback form described a score of 4 and 5 on the Likert scale (1-5, 1 = very unfamiliar,","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"O1-O33"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790936","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 Comprehensive and Modality Diverse Cervical Spine and Back Musculoskeletal Physical Exam Curriculum for Medical Students.","authors":"Konnor Davis, Aaron Frank, Trinidad Alcala-Arcos, Claire Godenzi, Melissa Allison, Clara Riggle, Sangeeta Sakaria, Ariana M Nelson, Alisa Wray, Brian Y Kim","doi":"10.21980/J8RQ0N","DOIUrl":"10.21980/J8RQ0N","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;The target audience for this small group session focused on the cervical spine and back musculoskeletal physical exam is medical students of all levels, although it is most useful for those early in their career such as first- and second-year medical students. These videos can also be used for other health care professionals such as physicians, physician associates, nurses, or nurse practitioners learning or refreshing their physical exam skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The physical exam (PE) is one of the core components of a physician's toolkit and learning to perform the neck and back exam is important. When done correctly, physical exams are a useful tool in evaluating patients and in creating a differential diagnosis. This is especially true for many patient concerns such as neck and back pain and in specialties such as neurology where diagnoses may be established using empiric observation by trained clinicians.1Beginning in 2019, the University of California, Irvine, School of Medicine (UCISOM) revised the physical exam portion of the Clinical Foundations (CF; \"doctoring\" course) which serves as a four-year longitudinal course for UCISOM students to learn, practice, and improve their history-taking, physical exam, differential diagnosis, and physicianship skills. Focusing on the PE component of the curriculum, a team of physicians reviewed the materials utilized to teach all PE sessions, and these videos specifically, the cervical spine and back musculoskeletal PE for the first- and second-year students. These materials included book chapters and third-party videos; additionally, student and physician feedback were reviewed. Previous student feedback felt that the third-party videos were not engaging and too long (run length per video was upwards of 60 minutes), and students requested videos with slightly more detail for future clinical exams. Utilizing the UCISOM clinical faculty and standardized patients (SP), a team of physician educators and students researched PE best practices for the cervical spine and back musculoskeletal physical exam and developed new video scripts and slides, and ultimately filmed, edited, and produced a series of eight videos demonstrating the cervical and back musculoskeletal PE maneuvers. These videos were one part of a series of fifty-six PE videos developed for learners of a comprehensive physical exam. Other portions of the series focus on vital signs, the cardiovascular exam, pulmonary exam, gastrointestinal exam, neurological exam, head, eyes, ears, nose and throat, and upper and lower extremity exams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this session, students will be able to: 1) demonstrate how to properly perform a cervical spine and back physical exam, 2) understand the reasoning behind cervical spine and back PE maneuvers, 3) identify the proper technique and equipment to use for the cervical spine and back PE, 4) understand normal an","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"SG1-SG8"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790855","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":"Case Report of Post-Operative Uvular Necrosis Following Intubation.","authors":"Laryssa Patti, Jal Trivedi, Mary Rometti","doi":"10.21980/J8065J","DOIUrl":"10.21980/J8065J","url":null,"abstract":"<p><p>Uvular necrosis is an uncommon but startling complication of manipulation of the posterior oropharynx, either via instrumentation or direct suctioning. Here, we present a patient who developed uvular necrosis after an urgent intubation. Although the uvular necrosis self-resolved via the auto-amputation of the uvula, the change to the uvula was emotionally distressing to the patient. As symptoms typically develop one to two days after the initial injury to the uvula, this diagnosis may be seen in the emergency department, rather than in the inpatient hospital setting.</p><p><strong>Topics: </strong>ENT, uvular disorders, complications of intubation, uvular disease.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V13-V15"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790940","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":"Beware of the Pediatric Limp: A Case of <i>Mycoplasma</i> Associated Acute Transverse Myelitis.","authors":"Michael Neff, Nicholas Xie, Joseph Fong, Gregory Podolej","doi":"10.21980/J8QQ1Q","DOIUrl":"10.21980/J8QQ1Q","url":null,"abstract":"<p><p>Gait disturbances in pediatric patients can be wrought with diagnostic pitfalls given the broad infectious, traumatic, musculoskeletal, and neurological etiologies. Furthermore, children can have difficulty communicating their pain and can be hard to examine. This case highlights the importance of slowing down to obtain a detailed history as well as perform a thorough exam in our pediatric patients, which can be challenging in a busy emergency department. We present a case of acute transverse myelitis (ATM) in a four-year-old male who presented with a one-day history of limp and bilateral leg pain with weight bearing. The caretakers reported a possible remote trauma from roughhousing at daycare. Neurological examination revealed significant abnormalities including bilateral patellar hyperreflexia, bilateral lower extremity weakness, clonus, and gait ataxia. A brain and spinal MRI revealed longitudinally extensive ATM with cord edema. Despite the lack of any evidence of infectious prodrome, cerebrospinal infectious analysis revealed <i>Mycoplasma pneumonia</i> as the causative agent. Treatment with intravenous (IV) methylprednisolone and azithromycin therapy led to eventual resolution of all neurological sequelae within a few weeks of discharge. This report emphasizes the importance of considering ATM in the differential of pediatric patients presenting with gait complaints, as well as the importance of a thorough neurologic exam, without which the diagnosis would have been missed.</p><p><strong>Topics: </strong>Pediatric emergency medicine, pediatric neurology, acute transverse myelitis, pediatric gait disturbance.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V22-V26"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790938","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 Longitudinal, Practical Curriculum for Faculty Development as New Coaches in Graduate Medical Education.","authors":"Simanjit K Mand, Chariti Gent, Sharon Barbour, Benjamin H Schnapp","doi":"10.21980/J88M08","DOIUrl":"10.21980/J88M08","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience and type of curriculum: &lt;/strong&gt;This coach development curriculum is designed for faculty physicians who have little to no prior experience with coaching in medical education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Length of curriculum: &lt;/strong&gt;The curriculum was developed for use over an entire academic year (12 months), but can be scaled to as few as 6 months due to the degree of schedule flexibility allowed by the structure of the educational approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;As coaching becomes more common in medical education, faculty educators are in a prime position to integrate a coaching approach in interactions with trainees. Because coaching is a unique skill set that requires targeted training and deliberate practice, there is a need for a detailed curriculum for faculty development as coaches. Adequate training will ensure faculty understand the coaching principles and have built a level of comfortability with the coaching approach prior to implementation with learners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational goals: &lt;/strong&gt;The aim of this curriculum is to provide a longitudinal, practical, and interactive coach training curriculum for faculty with no prior coaching experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;The educational strategies used in this curriculum include: asynchronous learning with assigned reading material to ensure a basic understanding of core coaching principles; high-yield synchronous sessions involving a mix of didactics, small-group discussion and reflection, and simulated case-based scenarios to provide opportunity for faculty to practice coaching skills. Each phase of the curriculum (three in total) uses a different educational strategy to address a specific goal and associated objectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;The educational content was evaluated with anonymous pre- and post-surveys that consisted of both Likert-style and open-ended questions. Surveys were designed based on the Kirkpatrick Evaluation Model. Three post-surveys were used to evaluate each phase of the curriculum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven faculty participated in this curriculum. Kirkpatrick Levels 1 and 3 were used to evaluate faculty reactions and behaviors, respectively, in response to the curriculum. Participants reported a high satisfaction with the overall curriculum, increased understanding of coaching approach, increased comfort with incorporating coaching relational and communication skills, and increased comfort in approaching select resident scenarios. Unexpected results include faculty reporting use of coaching skills in interpersonal interactions outside of the professional space and an improved bond with other faculty participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This curriculum is an effective method for increasing faculty knowledge and comfort with coaching skills. This curriculum and its materials can be adapted for other audiences who have no prior coaching experience and seek to learn","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"C1-C92"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790935","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":"Beta-Blocker Toxicity.","authors":"Amrita Vempati, P J Greene","doi":"10.21980/J8WD3X","DOIUrl":"10.21980/J8WD3X","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This simulation is intended to be used for emergency medicine (EM) residents (all levels) and 4th year medical students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Beta-blocker (BB) toxicity ranks seventh among the top 25 substances associated with fatalities, with a cardiovascular mortality rate of up to 1.4%.1,2 Patients with BB overdose may present with bradydysrhythmias, hypotension, hypoglycemia, altered mental status, and cardiogenic shock.3 Given that EM physicians are often the first to encounter such patients, EM learners need to be proficient in managing all aspects of BB toxicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of the session, learners will be able to: 1) manage a patient with hypotension, and bradycardia while maintaining a broad differential, 2) evaluate the causes of hypotension by utilizing ultrasound, 3) review when to initiate vasopressors and first-line agents for beta-blocker toxicity, 4) discuss treatment algorithm for BB toxicity including high-dose insulin and, 5) discuss the risk factors for suicide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This session employed high-fidelity simulation followed by an in-depth debriefing. It was conducted during the orientation for first-year EM residents, with 16 residents participating. The group was divided into two cohorts: eight residents actively managed the simulated patient, while the other eight observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Following the simulation and debriefing, participants were surveyed online using Google Form. The survey included the following questions: 1) the case was believable, 2) the case had right amount of complexity, 3) the case helped in improving medical knowledge and patient care, 4) I feel more confident in managing undifferentiated hypotension, 5) I feel more confident in managing BB overdose, 6) the simulation environment gave me a real-life experience and, 7) the debriefing session after simulation helped improve my knowledge. Responses were collected using a Likert scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ten participants completed the post-session survey. All respondents either agreed or strongly agreed that the case was effective in enhancing learning, medical knowledge, and patient care skills. Every participant found the debriefing session valuable and reported increased confidence in managing undifferentiated hypotension and BB toxicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The simulation session effectively educated participants on the management of BB toxicity, reinforcing key concepts such as the treatment of hypoglycemia, bradycardia, and hypotension. As the case unfolded, learners were required to assess refractory hypotension and initiate vasopressor therapy and specific treatments for BB toxicity. Overall, participants found the simulation beneficial for learning the management of BB overdose.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Topics: &lt;/strong&gt;Beta-blocker toxicity, refractory hypotension, bradyca","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"S25-S54"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790937","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":"Critical Care Transport: Blunt Polytrauma in Pregnancy.","authors":"Emma Rolf, Samuel Kefer, Jennifer Quinn, Ryan Newberry, Andrew Cathers, Craig Tschautscher, Brittney Bernardoni","doi":"10.21980/J81366","DOIUrl":"10.21980/J81366","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This simulation is designed for critical care transport nurses and attending physicians. It can also be adapted for critical care transport paramedics and respiratory therapists as well as emergency medicine nurses, residents, and attending physicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Emergency and trauma surgery practitioners routinely perform primary and secondary surveys as a systematic approach to trauma care. While this approach has broad applications, clinicians must also be versed in the nuances of caring for special populations in trauma. One such example is the obstetric patient. The incidence of trauma in pregnancy is increasing and is now the leading cause of non-obstetrical maternal death in the United States.1 Optimal maternal resuscitation depends on an understanding of the significant anatomic and physiologic changes of pregnancy and their influence on airway, breathing, and circulation.2,3,4This case presents a blunt polytrauma with unstable pelvic and lower extremity fractures precipitating hemorrhagic shock and the need for blood product transfusion. Learners must quickly adapt their clinical acumen and consider the influence of an obviously gravid patient on their resuscitation. Implementing and practicing the required skills allows for delivery of high-quality care. This session ensures that learners have a well-rounded understanding of scenarios that could occur in the resuscitation of a pregnant trauma patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;At the completion of this simulation participants will be able to 1) perform primary and secondary trauma surveys, 2) assess the neurovascular status of a tibia/fibula fracture, 3) appreciate anatomic and physiologic differences in pregnancy, 4) appropriately order analgesia and imaging, 5) recognize and treat hemorrhagic shock, 6) perform an extended focused assessment with sonography in trauma exam (eFAST) in undifferentiated hemorrhage, 7) identify a displaced pelvic fracture and properly apply a pelvic binder, and 8) obtain and interpret fetal heart rate using ultrasound.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This is a high-fidelity simulation portraying a 24-year-old pregnant female who requires hemodynamic resuscitation, pelvic and extremity fracture stabilization, and assessment of fetal heart rate. After completion of the simulation, learners will participate in a debrief and small group discussion that focuses on didactic knowledge and its application to patient care, crew resource management, and interprofessional communication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Learners were required to complete a pre- and post-simulation test evaluating their knowledge of pregnant trauma patient care. The results were then compared to evaluate whether the simulation improved participants' knowledge base. Learners also completed an evaluation of the simulation case itself using a 5-point Likert scale and free response. Feedback fro","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"S1-S24"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790943","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":"Case Report: Iatrogenic Bowel Perforation Following Dental Procedure.","authors":"Claire DeLong, Frederick Fiesseler","doi":"10.21980/J8CD38","DOIUrl":"10.21980/J8CD38","url":null,"abstract":"<p><p>Abdominal pain is a common complaint in emergency medicine, with a vast differential diagnosis. We report a case of a 42-year-old male presenting with two days of progressively worsening left lower quadrant (LLQ) pain. A CT scan of the abdomen demonstrated a small metallic foreign body. The patient had not ingested any grilled food, since this was the speculated etiology, given the concern for potentially ingesting a wire grill brush piece. Considering the significant pain and associated computer tomography (CT) findings, the patient was taken to the operating room. A 2 cm piece of metal wire was found perforating his small intestines. The patient remembered a recent visit to his orthodontist which was uneventful. Complications from orthodontic procedures are rare and typically benign. We report an unusual case of an iatrogenic small bowel perforation from an archwire. The patient had a full recovery.</p><p><strong>Topics: </strong>Orthodontist, bowel perforation, iatrogenic, archwire.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V5-V7"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790941","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}