Journal of education & teaching in emergency medicine最新文献

{"title":"Diagnosis of Sinonasal Carcinoma in the Emergency Department: A Case Report Highlighting Red Flag Symptoms.","authors":"Daniela Usuga, Ayomide Osunjima, Colin Danko","doi":"10.5070/M5.52257","DOIUrl":"10.5070/M5.52257","url":null,"abstract":"<p><p>Sinonasal carcinoma is a rare malignancy that often presents with nonspecific symptoms, making early diagnosis challenging. Delayed recognition can lead to disease progression and worse outcomes. This case report emphasizes the importance of early identification, prompt imaging, and multidisciplinary management. A 73-year-old male with a history of anemia and hypertension presented with progressive facial swelling, 20-pound weight loss, and vision loss in the left eye over two months. Initially misdiagnosed with bacterial sinusitis, his symptoms persisted. Examination revealed a proptotic left eye and a large obstructive nasal mass. Computed tomography (CT) and MRI (magnetic resonance imaging) demonstrated a destructive sinonasal mass with skull base and intracranial extension. A biopsy confirmed sinonasal carcinoma, and the patient was started on chemoradiation therapy due to the inoperability of the tumor. This case underscores the importance of recognizing red flag symptoms such as persistent facial swelling and neurological deficits. Multimodal imaging played a critical role in diagnosis. The literature suggests sinonasal carcinoma is often diagnosed late, reinforcing the need for early suspicion and specialist referral. Sinonasal carcinoma should be considered in patients with persistent facial or nasal symptoms. Timely imaging, biopsy, and interdisciplinary care are essential for optimizing outcomes.</p><p><strong>Topics: </strong>Facial masses, sinonasal carcinoma, nasal masses, facial swelling.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"V35-V40"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870568","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":"OptimEYEzing Emergency Skills: A Novel Model for Ocular Procedural Education for Emergency Medicine Residents.","authors":"Carrie Maupin, Ambika Anand, Grace Hickam, Stephen Miller","doi":"10.5070/M5.52212","DOIUrl":"10.5070/M5.52212","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This model for ocular procedural education is designed to instruct emergency medicine residents of all levels of training.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Ocular complaints are a common presentation to the emergency department (ED) with some studies quoting as many as two to three million ocular-related visits annually.1,2 These complaints can range from minor issues, such as corneal abrasions, to more serious conditions that require prompt evaluation and management, such as retrobulbar hematomas. Emergency medicine physicians are often the first-line providers assessing these complaints, so it is imperative that they feel adept in recognizing and managing these complaints.2Despite the frequency of ocular-related visits, ophthalmologic training among emergency medicine residents is often limited. Studies have reported that residents receive less than ten hours of formal ophthalmology training throughout their residency.2,3 One study revealed that many emergency medicine physicians in the United States are not confident in using basic ophthalmic tools, conducting eye exams, diagnosing ophthalmic complaints, or performing vision-saving procedures.2 This lack of formal training makes it difficult for residents to confidently diagnose and manage ocular conditions in the emergency department, both during residency and in their future practice. On review of the literature, there have been developments of procedural models for the practice of ophthalmology skills including removal of corneal foreign bodies utilizing swine eyes, tonometry using water balloons, and lateral canthotomy using a cadaver eye.4.5 However, cadavers can be very difficult to obtain, and expensive and swine eyes are not reusable or easy to store.There is a need for cost-effective, hands-on, ocular training models to help bridge this learning gap and increase residents' comfort with common ocular complaints and procedures - including foreign body removal, lateral canthotomy, fluorescein staining, and intraocular pressure (IOP) measurements. Integrating hands-on ocular training models into medical education can ultimately lead to better patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this session, learners will be able to: 1) identify signs and symptoms of ocular emergencies, 2) appraise for indications to perform ocular procedures, 3) demonstrate procedural competence in ocular foreign body removal, fluorescein staining, lateral canthotomy, and intraocular pressure (IOP) measurements, 4) relate increased procedural confidence with ocular procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;We developed two gelatin-based eye models that are low-cost and can be easily replicated. The first was created with Knox&lt;sup&gt;®&lt;/sup&gt; gelatin which can be easily made at home. The second was made with Humimic Medical™ synthetic gelatin which can be easily melted down and re-used. The gelatin base mimics the eye and allows for pra","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"I21-I33"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870661","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":"Woman with a Blackened Tongue: A Case Report.","authors":"Kyrillos Girgis, Cory Toomasian, Timothy Young","doi":"10.5070/M5.52329","DOIUrl":"10.5070/M5.52329","url":null,"abstract":"<p><p>Primary adrenal insufficiency is a rare disease characterized by deficient production of glucocorticoids with or without a deficiency of mineralocorticoids and adrenal androgens.1 This disease can present as a range of symptoms provoking a visit to the emergency department (ED). In this case, we present a 40-year-old female who reported tongue and gingival discoloration, unintentional weight loss, and skin hyperpigmentation. The patient was evaluated by an endocrinologist in the ED, received a dose of steroids in the ED, and discharged home with a prescription for steroids. This case report illustrates the distinctive tongue discoloration seen in primary adrenal insufficiency, highlighting the need for early recognition in the emergency setting to enable prompt and appropriate management.</p><p><strong>Topics: </strong>Endocrine, Addison's disease, primary adrenal insufficiency, black tongue, steroids, skin hyperpigmentation.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"V20-V22"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870665","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":"Enhancing Relationship-Centered Communication and Feedback in Emergency Medicine Through Applied Improvisation (EM-PROV).","authors":"Jordan Valentin, Abbas Husain, Brendan Freeman","doi":"10.5070/M5.52345","DOIUrl":"10.5070/M5.52345","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This small group session is intended for emergency medicine residents, medical students, and faculty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Improvisational techniques offer a novel and effective approach to teaching relationship-centered communication (RCC) and enhancing learner feedback in emergency medicine (EM).1 Improvisational theater (improv) is a form of spontaneous performance where all things or most things are made up on the spot. The \"yes, and\" principle-accepting a partner's idea (\"yes\") and building upon it (\"and\")-reflects core improv values such as affirmation, spontaneity, active listening, and empathy, all of which contribute to psychologically safe learning environments.1 It is an engaging practice that can foster creativity, build confidence, and enhance communication and social skills. Improv helps participants become more adaptable, attuned to emotional tone, and comfortable with uncertainty. These are critical elements of high-quality interpersonal feedback.2,3,4In the fast-paced EM setting, where teaching and supervision often occur in real time, the ability to deliver concise, respectful, and actionable feedback is essential. Improv-based learning provides a low-stakes space to explore tone, content, and delivery without fear of error. Prior studies demonstrate that improv improves communication performance, team collaboration, and confidence in difficult conversations.5,6 This module builds on that foundation by integrating structured feedback models and core RCC principles with improvisational exercises, allowing participants to refine skills through play, reflection, and peer interaction. As EM continues to emphasize communication and professionalism milestones, improv offers a compelling adjunct to traditional faculty or resident development by combining emotional literacy, interpersonal skills, and educational theory in a single interactive format.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this session, learners will be able to improve relationship-centered communication (RCC): 1) define \"yes, and\" and its role in RCC, and 2) demonstrate active listening and responsiveness using improvisational techniques such as \"yes, and,\" gift-giving, establishing scene, and callbacks. They will also be able to improve learner feedback: 1) define \"yes, and\" and its role in learner feedback, 2) review three evidence-based feedback models through a \"yes, and\" lens, and 3) practice improv techniques and deliver structured feedback in real-time peer scenarios using improvisational techniques such as \"yes, and,\" gift-giving, establishing scenes, and callbacks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;Using Kern's six-step approach, this curriculum was designed to address gaps in relationship-centered communication (RCC) and feedback skills among emergency medicine residents.7,8,9,10 The first two workshops focused on RCC, linking improvisational principles to patient communication throu","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"SG36-SG53"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870613","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":"Postpartum Complications Modified TBL.","authors":"Lauren E Lamparter","doi":"10.5070/M5.52264","DOIUrl":"10.5070/M5.52264","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;The intended audience for this modified TBL are resident physicians of all years, PGY1-4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Biological females represent 50% of the population we encounter in the emergency department (ED), and following delivery, the ED is often the main resource for postpartum patients to seek urgent/emergent care. The US is one of the most dangerous developed nations for pregnant women, with about 1/3 of pregnancy related deaths occurring in the postpartum period.1,2 It is presumed that many of these deaths are related to lack of support or insurance for close follow up after delivery.2 The three most common reasons for postpartum hospital readmission and mortality are cardiovascular related disorders (such as hypertension, eclampsia, and cardiomyopathy), hemorrhage, and infections.2,3 While most common, those are not exhaustive, and postpartum women are at risk for many other complications, such as breastfeeding related problems, which will cause them to present to the ED.As the front lines for patients with limited support or access to medical care, emergency physicians (EPs) need to understand how to recognize and intervene on the common complications faced by postpartum women. It is paramount that resident physicians have adequate training to consider and treat the unique medical concerns of this vulnerable population. This team-based learning (TBL) activity will prepare resident EPs to recognize and manage common postpartum complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this session learners will be able to: 1) identify the timeline in which postpartum complications typically occur, 2) discuss the specific differential diagnoses common in the postpartum period, 3) recognize risk factors for endometritis and mastitis, 4) recognize the presentation of postpartum cardiomyopathy and pituitary infarction, 5) formulate a treatment plan for postpartum endometritis including appropriate antibiotics and disposition, 6) formulate a treatment plan for mastitis including appropriate antibiotics and disposition, 7) formulate an appropriate assessment plan for pituitary infarction with appropriate disposition, and 8) formulate an appropriate treatment plan and disposition for postpartum cardiomyopathy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This is a modified team-based learning (mTBL) activity in which learners do not have learner responsible content (LRC) prior to the educational session. The multiple-choice cases can be used as an individual readiness assessment test (iRAT) followed by group discussion in a group readiness assessment test (gRAT), or without an iRAT and completed in small groups as a gRAT followed by instructor feedback and summary. Following the gRAT, there is a group application exercise (GAE) with summary cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;This mTBL was evaluated by learners immediately following the educational session using a post-part","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"T1-T20"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870659","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":"Stopping Fistula Hemorrhage without Bleeding Time and Money - A Low Cost, Low Resource Hemodialysis Fistula Model for Emergency Medicine Residents.","authors":"Mary Jordan, Thomas Yang, Michael Collier, Lacie Bailey","doi":"10.5070/M5.52204","DOIUrl":"10.5070/M5.52204","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This bleeding fistula model is designed to instruct emergency medicine residents and third- and fourth-year medical students on their emergency medicine rotation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The prevalence of end-stage renal disease (ESRD) has increased since 2001 (808,536 people in 2021 versus 409,226 in 2001).1 About 14% of the United States population has a decreased glomerular filtration rate (GFR), and the overall presence of ESRD in the population as of 2021 was 2,219 per million population.1 As of 2021, 87.7% of patients receiving dialysis were on hemodialysis.2 Around 60% of dialysis patients use a fistula for access.3 Patients with ESRD have a high emergency department utilization rate, and emergencies related to dialysis include hyperkalemia, volume overload, bleeding at the dialysis site, infection, aneurysm, and pseudoaneurysm .4-9 It is important for emergency medicine (EM) physicians to be able to intervene quickly on life-threatening complications related to dialysis, including vascular access hemorrhage. There are approximately 250 deaths related to vascular access hemorrhages yearly, and it accounts for 0.4% of deaths in patients on dialysis.4 Patients with an initial presentation of hemorrhage from their vascular access site are also at risk for re-bleeding, and 80% of patients with bleeding die at home.10 Due to the high acuity and low occurrence (HALO) of bleeding fistulas, procedural knowledge of hemorrhage control and a thorough understanding of dialysis-related complications is paramount for EM physicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;After using the task trainer bleeding fistula model, learners will be able to: 1) identify vascular access hemorrhage as an emergency presentation in dialysis patients; 2) execute a stepwise approach to manage a bleeding fistula; 3) demonstrate effective hemorrhage control for a patient with uncontrolled bleeding from their fistula, including choice of appropriate suture material and suturing technique; and 4) discuss pitfalls of hemorrhage control in patients with fistulas, including risks of tourniquet use and complications related to clot formation at the fistula site.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;The novel bleeding fistula model was embedded within a high-fidelity simulation for learners as part of weekly EM resident didactics. Learners received a pre-brief session to the simulation case. They then participated in a simulation scenario using a high-fidelity manikin with the bleeding fistula model on the manikin's arm. The bleeding fistula model allowed learners to progress through a stepwise approach to achieve hemorrhage control in a patient presenting with bleeding from a dialysis access site. After the simulation, learners participated in a simulation debrief, which included a procedural skills workshop.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;This simulation scenario and model have been used in two academic year d","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"I1-I20"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870733","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 Woman's Infertility Journey Complicated by Severe Ovarian Hyperstimulation Syndrome - A Case Report.","authors":"Sukaynah Khetani, Justin Hutchison, C Michael Lee","doi":"10.5070/M5.52309","DOIUrl":"10.5070/M5.52309","url":null,"abstract":"<p><p>Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of assisted reproductive technology (ART). Here, we present the case report of a 30-year-old female undergoing infertility treatment who presented to the emergency department (ED) with nausea and vomiting, abdominal distention, and shortness of breath. On physical exam, she had notable ascites. Computed tomography (CT) of the abdomen and pelvis and pelvic ultrasound (US) revealed significant ascites and enlarged ovaries with multiple cysts. She was diagnosed with severe OHSS and admitted to obstetrics and gynecology (OBGYN) service for five days where she underwent intravenous (IV) hydration and paracentesis. This case report reviews the clinical presentation, categorization, management, and prevention of OHSS and provides examples of imaging findings consistent with the condition.</p><p><strong>Topics: </strong>Infertility, obstetrics, assisted reproductive technology, ovarian hyperstimulation, third-spacing.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"V23-V29"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870619","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 Rash That Didn't Blanch: A Case Report of Adult-Onset IgA Vasculitis with Underlying Cirrhosis and IgA Nephropathy.","authors":"Elaha Noori, Tyler Rigdon, Omar Darwish, Danielle Matonis","doi":"10.5070/M5.52253","DOIUrl":"10.5070/M5.52253","url":null,"abstract":"<p><p>Rashes are a common presentation in the emergency department (ED) and can signify a wide variety of underlying conditions. Early recognition of serious dermatologic rashes in the acute care setting is essential in improving patient outcomes. Here we describe the case of a 69-year-old female with a medical history of cirrhosis with ascites, chronic kidney disease (CKD) secondary to immunoglobulin A (IgA) nephropathy, and hypertension who presented to the ED with a chief complaint of foot pain with an associated rash. On examination, she had tender purpura with bilateral symmetric pedal edema. Initial work up in the ED was significant for mildly elevated inflammatory markers. Given the concern for vasculitis, dermatology was consulted; punch biopsy confirmed IgA vasculitis. The patient was subsequently admitted for acute renal injury and started on corticosteroids. After a week-long inpatient stay, she was discharged home in stable condition. This case highlights the importance of maintaining a broad differential diagnosis for purpuric rashes, recognizing when specialty consultation is warranted, and understanding the pathophysiologic interplay between IgA vasculitis, liver cirrhosis, and IgA nephropathy.</p><p><strong>Topics: </strong>Vasculitis, IgA vasculitis, Henoch-Schönlein purpura, IgA nephropathy, dermatology.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"V10-V15"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870640","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":"Midline Catheters: A Novel Curriculum for Emergency Medicine Residents.","authors":"Braden W McIntosh, Brian Allen, Michael Truax, Mitchell Hymowitz, Greggory Davis","doi":"10.5070/M5.52243","DOIUrl":"10.5070/M5.52243","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience and type of curriculum: &lt;/strong&gt;This curriculum is designed for all levels of emergency medicine (EM) Residents. The curriculum covers the appropriate anatomy, indications, contraindications, and specific steps for placement of midline catheters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Length of curriculum: &lt;/strong&gt;Three one-hour sessions over a period of three months or a single three-hour session.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Midline catheters have become more mainstream in the emergency department as a replacement for central lines. They are readily insertable into a peripheral vein and useful for access, blood draws, and medication administration, which are well known benefits of peripheral lines. They also offer long-term reliable access and are becoming more accepted for caustic medication administration, which are clear indications for central line placement. They are significantly more comfortable than a central line and may be associated with lower rates of catheter related bloodstream infections (CRBSI) when compared to peripherally inserted central catheter (PICC) lines.1 These combined advantages have led to increasing interest in midline use in the emergency department. Unfortunately, EM residents are often not educated on the indications for midline catheters and are not trained in placing them either. We propose a midline curriculum for EM resident success in this area.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational goals: &lt;/strong&gt;The purpose of this curriculum is to teach emergency medicine residents how to place and utilize midline catheters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;The educational strategies used in this curriculum include written and skills assessments as well as in-person lectures, and asynchronous learning. Specifically, there is a pre- intervention and post-intervention knowledge assessment as well as a pre- and post-skills assessment and skills check list. The knowledge assessments are conducted using written multiple-choice exams, and the skills curriculum evaluation is performed with task trainers and instructor feedback.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Educational content was evaluated by learners via online survey. Efficacy of the educational content was assessed using scores and feedback from the written pre- and post-intervention examinations and procedural skills assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-nine residents completed the study curriculum. Overall, we found the written exam score improved from pre- to post-intervention by roughly 5% (75% to 80% on average). The time to midline placement from tourniquet to vessel catheterization was significantly improved from pre-intervention at 7 minutes, 32 seconds to post-intervention at 5 minutes, 0 seconds. The post-curriculum survey taken by participants demonstrated an increased self-reported likelihood of placing a midline on a patient and improved self-reported core knowledge. However, self-reported clinical skills did not improve significan","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"C1-C27"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870684","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 on an Open Fracture Dislocation Injury of the Proximal Phalanx of the Thumb Resulting from Playing Cricket.","authors":"Michael R Chiang, Morgan Kemerling, Rahul Pentaparthi, Avi Ruderman","doi":"10.5070/M5.52278","DOIUrl":"10.5070/M5.52278","url":null,"abstract":"<p><p>Open fractures represent high acuity injuries requiring rapid evaluation and management for optimal outcomes. In this report, we discuss a patient presenting with an open fracture of the proximal phalanx of the right thumb with interphalangeal (IP) joint dislocation. The patient reported that the injury occurred in the setting of trauma from catching a cricket ball, experiencing immediate severe pain and bleeding. Key interventions in the emergency department included rapid x-ray evaluation of the injury, administration of cefazolin and tetanus vaccine, pain control, covering the exposed bone in moist gauze, and involvement of the hand surgery team for bedside irrigation and reduction. He underwent open reduction and internal fixation of the fracture the next day. He was followed in the hand clinic and was doing well at the 12-week appointment. In summary, we report on an open fracture and dislocation of the proximal phalanx of the thumb secondary to a traumatic cricket injury. Early mobilization of the surgical team and adjunctive prophylaxis with cefazolin and updated tetanus were key measures in the emergency department for achieving optimal outcomes.</p><p><strong>Topics: </strong>Finger injury, hand injury, open fracture, dislocation, cricket, sports injuries.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"11 2","pages":"V16-V19"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870638","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}