Journal of education & teaching in emergency medicine最新文献

{"title":"Case Report of Herpes Zoster Ophthalmicus with Concurrent Parotitis.","authors":"Serena Tally,&nbsp;Michelle Brown,&nbsp;Edmund Hsu","doi":"10.21980/J8R93N","DOIUrl":"https://doi.org/10.21980/J8R93N","url":null,"abstract":"<p><p>A 36-year-old immunocompetent female presented to the emergency department (ED) with five days of headache and left-sided facial pain. Physical exam showed conjunctival injection of the left eye with multiple vesicular lesions distributed along the V1 dermatome. Labs were remarkable for mild elevation in erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) with no elevation in white blood cell (WBC) count. Computed tomography (CT) with contrast of the neck revealed soft tissue stranding around the parotid gland. The patient was diagnosed with herpes zoster ophthalmicus (HZO) with concurrent ipsilateral parotitis and subsequently treated with valacyclovir, ofloxacin eye drops, topical erythromycin ointment and amoxicillin/clavulanic acid. Upon follow-up ten days after discharge, the patient noted marked improvement in her symptoms and reduction in pain. To our knowledge, this is the first case described in medical literature of a female patient with HZO and ipsilateral parotitis.</p><p><strong>Topics: </strong>Herpes zoster opthalmicus, varicella-zoster virus, parotitis.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 2","pages":"V6-V10"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827752","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 Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator.","authors":"Nicole Finney,&nbsp;Eli Soyfer,&nbsp;Rory Schwan,&nbsp;Lindsey C Spiegelman","doi":"10.21980/J8KM02","DOIUrl":"https://doi.org/10.21980/J8KM02","url":null,"abstract":"<p><p>Syphilis is a progressive sexually transmitted infection that has a wide variety of presentations depending on the disease stage. These variable presentations can make it difficult to differentiate syphilis from other diseases. While tertiary syphilis is less common in the United States compared to primary or secondary syphilis, recognition of the varied manifestations of advanced syphilis can help providers accurately diagnose this disease to help prevent continued spread. In this case report, we present a patient with a history of bilateral palmar wounds. The patient had presented to multiple emergency departments without a diagnosis of syphilis. Upon subsequent emergency department visits, the patient was diagnosed with tertiary syphilis, started on a course of penicillin, and evaluated by dermatology. However, the patient left against medical advice prior to further evaluation and treatment. From this case report, we have learned the importance of considering tertiary syphilis gummas in the differential diagnosis of atypical skin wounds.</p><p><strong>Topics: </strong>Sexually transmitted infection (sti), syphilis, tertiary syphilis, gummas, dermatologic lesions.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 2","pages":"V11-V15"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836881","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":"Flipping Tickborne Illnesses with Infographics.","authors":"Daniel Johnson,&nbsp;Annahieta Kalantari","doi":"10.21980/J83H12","DOIUrl":"https://doi.org/10.21980/J83H12","url":null,"abstract":"<p><strong>Audience: </strong>This interactive module is designed for implementation within an Emergency Medicine Residency program. The target audience is post-year-graduate one to post-year-graduate four residents, medical students, physician assistant postgraduate trainees, physician assistant students, and physician assistants.</p><p><strong>Introduction: </strong>A knowledge of tickborne illness represents a critical component of infectious disease education for Emergency Medicine residents. Ticks that harbor these organisms are highly endemic to the continental United States and zoonotic infections are a critical differential diagnosis in the evaluation of patients in the Emergency Department.1 There is significant morbidity and mortality associated with tickborne diseases, and many of the signs and symptoms can mimic other common presentations. While these illnesses can present a diagnostic challenge and coinfection does occur, treatment is generally straightforward and readily available.2 An understanding of vectors and rates of transmission in a geographic area can foster a high clinical suspicion and ensure that effective treatment is administered.3.</p><p><strong>Educational objectives: </strong>After participation in this module, learners will be able to 1) list the causative agents for Lyme Disease, Babesiosis, Tularemia, Ehrlichiosis, Anaplasmosis, Tick Paralysis, Rocky Mountain Spotted Fever, and Powassan Virus, 2) identify different clinical features to distinguish the different presentations of tickborne illnesses, and 3) provide the appropriate treatments for each illness.</p><p><strong>Educational methods: </strong>This module utilized the flipped classroom model of education for independent learning, along with small group discussion as the in-class active learning strategy. Learners independently completed pre-assigned readings and questions based on the readings. In didactics sessions, learners created an infographic of each of the tickborne illnesses. Each infographic was shared with the entire group in the final 30 minutes of the didactic session.</p><p><strong>Research methods: </strong>Each learner completed a pre-test prior to receiving the educational preparatory materials. At the end of the session, participants completed a post-test, a Likert scale survey to evaluate the program, and a free text box to provide qualitative feedback on the session. Efficacy of the education content was determined by post-test scores.</p><p><strong>Results: </strong>Unfortunately, the pre-test file was corrupted by a virus and inaccessible, resulting in no comparison data. A post-course test of 4 questions and a Likert scale evaluation was completed by 22 participants. 72.7% of the participants felt the session increased his/her knowledge on the topic, and 59% enjoyed the format of the session. Fifty-percent of the participants missed zero post-course test questions, 27% missed one question, and 22% missed two or more questions. Comment","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 2","pages":"SG1-SG14"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836874","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 Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator","authors":"Nicole Finney, Eli M Soyfer, Rory Schwan, Lindsey C Spiegelman","doi":"10.5070/m58260902","DOIUrl":"https://doi.org/10.5070/m58260902","url":null,"abstract":"Syphilis is a progressive sexually transmitted infection that has a wide variety of presentations depending on the disease stage. These variable presentations can make it difficult to differentiate syphilis from other diseases. While tertiary syphilis is less common in the United States compared to primary or secondary syphilis, recognition of the varied manifestations of advanced syphilis can help providers accurately diagnose this disease to help prevent continued spread. In this case report, we present a patient with a history of bilateral palmar wounds. The patient had presented to multiple emergency departments without a diagnosis of syphilis. Upon subsequent emergency department visits, the patient was diagnosed with tertiary syphilis, started on a course of penicillin, and evaluated by dermatology. However, the patient left against medical advice prior to further evaluation and treatment. From this case report, we have learned the importance of considering tertiary syphilis gummas in the differential diagnosis of atypical skin wounds. Topics Sexually transmitted infection (sti), syphilis, tertiary syphilis, gummas, dermatologic lesions.","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"104 1","pages":"V11 - V15"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85212666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of community-acquired tuberculosis in an infant presenting with pneumonia refractory to antibiotic therapy","authors":"Audra Iness, Andrea Cruz, Scott Dorfman, Esther Sampayo","doi":"10.5070/m58160086","DOIUrl":"https://doi.org/10.5070/m58160086","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticholinergic Toxicity","authors":"C. McCoy, R. Honda","doi":"10.5070/m58160091","DOIUrl":"https://doi.org/10.5070/m58160091","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47041060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Findings of Small Bowel Diverticulitis A Case Report","authors":"Albert Zhou, Sarah Bella, Amy Patwa","doi":"10.5070/m58160074","DOIUrl":"https://doi.org/10.5070/m58160074","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Dissection Case Report","authors":"Chelsea Bunce, Christopher Bryczkowski, Mary Rometti","doi":"10.5070/m58160075","DOIUrl":"https://doi.org/10.5070/m58160075","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Community-Acquired Tuberculosis in an Infant Presenting with Pneumonia Refractory to Antibiotic Therapy.","authors":"Audra N Iness,&nbsp;Andrea T Cruz,&nbsp;Scott R Dorfman,&nbsp;Esther M Sampayo","doi":"10.21980/J8X07M","DOIUrl":"https://doi.org/10.21980/J8X07M","url":null,"abstract":"<p><p>Infant tuberculosis (TB) is a rare but potentially deadly infection and difficult to diagnose, especially in infants who may present with non-specific symptoms. Here, we report a case of an United States-born term infant with community-acquired miliary TB and no confirmed TB exposure history. The patient initially presented with respiratory distress at seven weeks of life with chest radiograph showing a right lower lobe (RLL) infiltrate. After failing multiple courses of treatment for community-acquired pneumonia and developing growth faltering, the patient had imaging findings suggestive of TB infection with CNS involvement. The diagnosis of TB was confirmed by QuantiFERON and purified protein derivative (PPD). In infants who fail conventional treatment for bacterial pneumonia, the differential should be broadened to consider alternative etiologies. Additionally, brain imaging should be performed in cases of disseminated TB despite negative cerebrospinal fluid (CSF) studies since these patients are at high risk of central nervous system (CNS) involvement.</p><p><strong>Topics: </strong>Tuberculosis, pneumonia, pediatrics, growth faltering.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"V18-V22"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891617","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":"Anticholinergic Toxicity in the Emergency Department.","authors":"C Eric McCoy,&nbsp;Reid Honda","doi":"10.21980/J8D07Z","DOIUrl":"https://doi.org/10.21980/J8D07Z","url":null,"abstract":"<p><strong>Audience: </strong>Emergency medicine residents, internal medicine residents, family medicine residents, community physicians, pediatricians, toxicology fellows.</p><p><strong>Introduction: </strong>There are over 600 compounds which contain anticholinergic properties.1 Medications with anticholinergic properties include antihistamines, atropine, tricyclic antidepressants, antipsychotics, topical mydriatics, antispasmodics, sleep aids, and cold preparations. 1-4 Plants that possess anticholinergic properties such as jimson weed, and street drugs cut with anticholinergics such as scopolamine are sources of accidental or intentional ingestion.1,2,4 Anticholinergic toxicity can cause a myriad of signs and symptoms, including agitation, seizures, hyperthermia, cardiac dysrhythmias, and death. Since poisoning from anticholinergic medications is frequently encountered in the emergency department, is it essential that emergency physicians be familiar with how to manage this toxidrome. This simulation case will allow the learner to evaluate and manage a patient presenting with anticholinergic toxicity.</p><p><strong>Educational objectives: </strong>By the end of this simulation case, learners will be able to: 1) describe the classic clinical presentation of anticholinergic toxicity, 2) discuss common medications and substances that may lead to anticholinergic toxicity, 3) recognize the electrocardiogram (ECG) findings in anticholinergic toxicity that require specific therapy, and 4) review the management of anticholinergic toxicity.</p><p><strong>Educational methods: </strong>This simulation is taught using a high- or moderate-fidelity manikin.</p><p><strong>Research methods: </strong>The educational content was evaluated by the learners immediately after completion and debriefing of the scenario. This case was initially piloted with approximately twenty emergency medicine residents. The group was comprised of first, second-, and third-year residents from a three-year emergency medicine residency. The efficacy of the content was assessed by oral feedback.</p><p><strong>Results: </strong>Overall, the case was well received by learners, who felt it was useful and were engaged throughout the session. The overall feedback was positive and the case was well-received by learners.</p><p><strong>Discussion: </strong>This scenario was eventually tested on over 100 learners over the course of several years, and the overall feedback was positive. It was found to be effective when debriefing sessions using various debriefing techniques (such as advocacy/inquiry) were utilized to discuss both the learners' performance in the case, as well as the debriefing pearls (located at the end of this manuscript).</p><p><strong>Topics: </strong>Anticholinergic toxicity, altered mental status, toxicology.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"S25-S47"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9837115","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}