Journal of education & teaching in emergency medicine最新文献

{"title":"A Case Report of Calciphylaxis.","authors":"Kim Hoang, Tien Lu, Alex Dang, Danielle Matonis","doi":"10.21980/J8KW8V","DOIUrl":"10.21980/J8KW8V","url":null,"abstract":"<p><p>Calciphylaxis is a rare condition that is not well understood but is known to carry significant morbidity and mortality. We present a 44-year-old male with a history of end-stage renal disease on dialysis complaining of increasingly painful chronic wounds. The patient's physical exam was remarkable for ulcerated, bilateral anterior leg wounds with large areas of eschar along with purulent drainage. He was admitted to the hospital for intravenous antibiotics, wound care, and specialist consultation for treatment of calciphylaxis. This case report provides an overview of the key clinical features of calciphylaxis and reviews potential treatment strategies for this life-threatening condition.</p><p><strong>Topics: </strong>Calciphylaxis, chronic kidney disease, end-stage renal disease, wound infection, wound care.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V27-V30"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790853","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 Incarcerated Gastric Volvulus and Splenic Herniation in Undiagnosed Congenital Diaphragmatic Hernia in an Infant.","authors":"Kate R Gelman, Torren A Kalaskey, Federico G Seifarth","doi":"10.21980/J8VD27","DOIUrl":"10.21980/J8VD27","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia is usually diagnosed prenatally and surgically repaired within the first few days of life. It is very rarely associated with acute gastric volvulus, an uncommon surgical emergency in children. A male infant with atypical presentation of acute gastric volvulus was diagnosed and treated by a swift-acting team across two medical centers. The patient presented with generalized abdominal distention and non-productive retching. Upper gastrointestinal series diagnosed acute gastric volvulus. During laparoscopic intervention, the volvulized stomach and the spleen were identified within an undiagnosed congenital diaphragmatic hernia. Corrective surgery was performed, and the patient tolerated a regular diet within days and continues to do well. Given the emergent nature of acute gastric volvulus in children, a high index of suspicion is warranted to quickly initiate potentially life-saving diagnostics and treatment.</p><p><strong>Topics: </strong>Acute gastric volvulus, diaphragmatic hernia, pediatric.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V16-V21"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790939","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 Facial Swelling and Crepitus Following a Dental Procedure.","authors":"Shady Mikhail, George Mina, Alisa Wray, Danielle Matonis","doi":"10.21980/J83W8H","DOIUrl":"10.21980/J83W8H","url":null,"abstract":"<p><p>Subcutaneous emphysema (SE) is a rare but significant complication following dental procedures characterized by the presence of air in the subcutaneous tissue. This case report presents a 67-year-old male who developed right-sided facial swelling after tooth extraction, a procedure executed with high-power dental tools. Clinical findings included facial swelling and crepitus with no lip involvement, differentiating SE from an allergic reaction and hematoma. Diagnostic imaging through computed tomography (CT) and chest X-ray confirmed SE, showing diffuse subcutaneous air in facial and neck soft tissues. Initial management in the emergency department (ED) involved administration of antihistamines, corticosteroids, antibiotics, and otolaryngology (ENT) consultation with close monitoring for airway compromise. This case underscores the importance of including SE in differential diagnoses for post-dental procedure swelling, the effectiveness of CT imaging in SE identification, and the importance of early detection and treatment to prevent severe complications like respiratory and cardiac issues.</p><p><strong>Topics: </strong>Subcutaneous emphysema; facial swelling; computed tomography (CT); dental procedure; emergency medicine.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"V8-V12"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790854","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":"Cognitive Errors and Debiasing.","authors":"Joshua Ginsburg","doi":"10.21980/J84W96","DOIUrl":"10.21980/J84W96","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Although this lecture was given to first-year residents, it is also appropriate for upper-level residents, medical students, fellows, and faculty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Medical errors are largely due to errors of cognition rather than lack of knowledge.1 The cognitive processes that underlie these errors are often explained using Dual Process Theory, which posits that we engage in either fast, intuitive, low-effort System 1 thinking or slow, analytical, high-effort System 2 thinking. Although System 1 thinking is crucial for efficient emergency medicine practice, it is susceptible to the biases that cause cognitive errors. Research to date is mixed regarding the effect of educational interventions aimed at reducing cognitive bias but tends to show a benefit to cognitive bias training over a variety of outcome measures.2 Many experts therefore believe that physicians should be taught about cognitive biases and debiasing strategies in an effort to reduce medical errors.3,4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this lecture, learners should be able to, 1) Define dual process theory, 2) identify common cognitive biases, 3) recognize high-risk situations for cognitive errors, and 3) discuss debiasing strategies and integrate one strategy into your workflow.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This interactive lecture was created in PowerPoint and delivered in-person to 14 first-year residents during their \"Intern Curriculum,\" a monthly meeting separate from the residency-wide conference. The lecture took 30 minutes to deliver.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Residents responded to pre- and post-lecture Likert scale surveys regarding their knowledge of cognitive biases and debiasing strategies, as well as a post-lecture survey regarding the quality of the lecture, the relevance of the content, and the likelihood of making changes to their practice based on the lecture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14 residents responded to the survey, and all residents completed both the pre-lecture and post-lecture questions. In the pre-lecture survey, 35.7% (5) of participants reported that they had good or extensive knowledge of cognitive biases, and 7.1% (1) of participants reported that they had good or extensive knowledge of debiasing strategies. In the post-lecture survey, 85.7% (12) of participants reported that they had good or extensive knowledge of cognitive biases, and 78.6% (11) of participants reported that they had good or extensive knowledge of debiasing strategies. All (14) participants felt the lecture was of good or excellent quality, 92.9% (13) felt it was very or extremely relevant to them as emergency medicine physicians, and 100% (14) reported they were likely to make changes to their practice based on this lecture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The results of the survey show that residents perceived increased knowledge of both cognitive error","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 3","pages":"L1-L6"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790942","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":"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":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;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 &lt;i&gt;in situ&lt;/i&gt;, 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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;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":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;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":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Medical students on required fourth-year emergency medicine clerkship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This case is meant to be used as an oral board or white board case for medical students and interns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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}