Journal of education & teaching in emergency medicine最新文献

{"title":"A Homemade, Cost-Effective, Realistic Pelvic Exam Model.","authors":"Jessie Godsey,&nbsp;Ilya Kott,&nbsp;Adrienne Payden,&nbsp;Patricia Ward","doi":"10.21980/J8HM0F","DOIUrl":"https://doi.org/10.21980/J8HM0F","url":null,"abstract":"<p><strong>Audience: </strong>This innovation is intended to instruct medical students, residents of all levels, and mid-level practitioners.</p><p><strong>Background: </strong>Pelvic examinations are essential components to clinical practice but are challenging to teach, learn, and practice on live patients secondary to patient comfort because this is an invasive procedure.1 Resident physicians and medical students traditionally learn these methods through observation while actively working in their department or clinics.2 Simulation models can improve a provider's competency and confidence performing pelvic examinations which improve patient comfort and exam accuracy.3 One barrier to simulation training is the cost of the pelvic simulator models. A basic pelvic exam simulator costs $365.4 The cost is high, therefore limiting the availability of a simulation model accessible to residency programs across the country. This barrier to pelvic models was overcome by developing a homemade alternative for cervical examination and collection of screening swabs. The model created can be easily manufactured by students, residents, and faculty alike for less than $20 and approximately two hours of manufacturing time. A literature review was conducted to find similar products and other production methods for a pelvic examination model. No comparable models were found.This is a guide to utilizing supplies from a local dollar store combined with home recycling products and a few common crafting tools to create a realistic pelvic examination model.</p><p><strong>Educational objectives: </strong>After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy.</p><p><strong>Educational methods: </strong>The pelvic exam model is utilized to effectively teach proper technique for pelvic examinations. This model can be utilized to teach medical students, incoming residents, and new mid-levels. Senior residents, experienced mid-levels, or attendings who are experienced in completing pelvic examinations can easily utilize this model to teach proper technique.</p><p><strong>Research methods: </strong>The data for this study was collected from a single graduate medical education program in Detroit, Michigan. This was designed as a single blind survey where the reviewer's identities were kept anonymous from the data collectors. Surveys were collected from attendings, residents, mid-level providers, and medical students across specialties of emergency medicine, family medicine, obstetrics and gynecology.</p><p><strong>Results: </strong>A total of 77 individuals tested the homemade model and compared it to a pelvic exam on a live patient as well as a commercial pelvic exam model. Survey results showed the low-cost homemade model was just as effective as a comme","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988940","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 Patient with Generalized Weakness - A Case Report.","authors":"Darby Graham,&nbsp;Manparbodh Kaur,&nbsp;John Costumbrado,&nbsp;Sassan Ghassemzadeh","doi":"10.21980/J8593C","DOIUrl":"https://doi.org/10.21980/J8593C","url":null,"abstract":"<p><p>Emphysematous pyelonephritis (EPN) is a rare and life-threatening sequalae of a urinary tract infection marked by a gas-producing necrotizing infection of the renal parenchyma requiring prompt treatment. It has been found to be correlated with uncontrolled diabetes mellitus and is more common in females due to their increased susceptibility to urinary tract infections. Early recognition and treatment of EPN are essential to improve the patient's prognosis and prevent further complications. In this case we highlight a progressive case of pyelonephritis complicated by emphysematous abscess formation requiring surgical management. A 49-year-old female with a history of diabetes, hypertension, asthma, and lupus who presented to the emergency department (ED) for evaluation of generalized weakness. Lactate was elevated and urinalysis was suggestive of infection. A computed tomography (CT) scan of the abdomen and pelvis revealed a large subcapsular fluid collection with multiple gas and air-fluid levels along the right kidney, as well as another suspected fluid collection adjacent to the upper pole of the right kidney. The findings suggested complicated pyelonephritis with emphysematous abscess formation. Urology was consulted and they suggested a perinephric drain be placed by interventional radiology (IR). The patient progressed well and was ultimately discharged days later in stable condition. Despite its rarity, healthcare providers should consider infectious processes such as EPN in the differential for generalized weakness and promptly initiate appropriate diagnostic and therapeutic measures.</p><p><strong>Topics: </strong>Weakness, sepsis, urology, CT scan.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995309","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 Invasive Mucormycosis in a COVID-19 Positive and Newly-Diagnosed Diabetic Patient.","authors":"Konnor Davis,&nbsp;Roy Almog,&nbsp;Yuval Peleg,&nbsp;Lindsey Spiegelman","doi":"10.21980/J81M1G","DOIUrl":"https://doi.org/10.21980/J81M1G","url":null,"abstract":"<p><p>This is a case report of a 46-year-old female with undiagnosed diabetes, COVID-19, and mucormycosis. Mucormycosis is a rare, rapidly progressive disease process characterized by an insidious onset of vague symptoms and is associated with a high mortality rate. The patient initially presented at two outside ophthalmology clinics due to right eye pain and was prescribed steroids. Upon presentation to our institution's Emergency Department, the patient's pain had significantly increased along with new symptoms of ptosis and failure to adduct the right eye. Laboratory results demonstrated leukocytosis, hyperglycemia, and a positive SARS-CoV-2 test. Magnetic resonance imaging confirmed a diagnosis of mucormycosis and the patient underwent surgery and began intravenous antifungal therapy. This discussion addresses the presenting features of mucormycosis in the emergency department while highlighting the need for immediate investigation due to the fungi's rapidly progressive nature.</p><p><strong>Topics: </strong>Mucormycosis, mucor, diabetes, COVID-19, ROCM.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988937","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 Man with Sore Throat—A Case Report","authors":"Nathan Mercado, Sawyer Schuljak, Daniel Ng, Curtis Knight, Allison Woodall, John Costumbrado","doi":"10.5070/m58260904","DOIUrl":"https://doi.org/10.5070/m58260904","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135573181","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 Report of Subtle EKG Abnormalities in Acute Coronary Syndromes Indicative of Type One Myocardial Infarction","authors":"Paige Matijasich, Patrick Bruss, Gregory Reinhold, Zachary Koppelmann","doi":"10.5070/m58260893","DOIUrl":"https://doi.org/10.5070/m58260893","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135671141","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":"Construction of Soft Prep Cadaver Pericardiocentesis Training Model and Implementation Among Emergency Medicine Residents","authors":"Kathryn Oskar, Dana Stearns","doi":"10.5070/m58260895","DOIUrl":"https://doi.org/10.5070/m58260895","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135671144","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":"Case Report of Herpes Zoster Ophthalmicus with Concurrent Parotitis","authors":"Serena Tally, Michelle Brown, Edmund Hsu","doi":"10.5070/m58260900","DOIUrl":"https://doi.org/10.5070/m58260900","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135573180","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 Report of Subtle EKG Abnormalities in Acute Coronary Syndromes Indicative of Type One Myocardial Infarction.","authors":"Paige Matijasich, Patrick Bruss, Gregory Reinhold, Zachary Koppelmann","doi":"10.21980/J8W06X","DOIUrl":"10.21980/J8W06X","url":null,"abstract":"<p><p>This case report discusses a patient who had subtle EKG abnormalities that were indicative of a pathological amount of coronary artery disease resulting in occlusion of the right coronary artery (RCA) even though ST-elevation criteria for STEMI were not initially present. In the proper clinical setting, focal repolarization abnormalities in conjunction with cardiac risk factors and cardiac symptoms may indicate a high probability of a pathological amount of coronary disease that warrants emergent intervention. We report a case of a 54-year-old male with cardiac risk factors and cardiac symptoms who presented to the emergency department (ED). Initial EKG, while technically abnormal, was not diagnostic. The point of care troponin was elevated at 0.10 ng/mL. Patient ultimately went to the catheterization lab where he was found to have an occlusion of the RCA and left circumflex artery which required stenting.</p><p><strong>Topics: </strong>Electrocardiogram, ECG, cardiology, myocardial infarction.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827751","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":"Acute Exacerbation of COPD.","authors":"Dominic Pappas, Amrita Vempati","doi":"10.21980/J8V070","DOIUrl":"10.21980/J8V070","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;This case is targeted to emergency medicine residents of all levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Shortness of breath (SOB) is one of the top ten most common chief complaints seen in the Emergency Department, accounting for close to 10% of presenting complaints.1 An acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a frequent culprit, accounting for roughly 15.4 million visits and 730,000 hospitalizations per year.2 The diagnosis of treatment of mild to moderate AECOPD can be relatively uncomplicated; however, multiple factors can increase the complexity of management and pose additional challenges that the emergency physician (EP) must be prepared for. Severe AECOPD can necessitate the need for both Non-invasive positive pressure ventilator (NIPPV) such as bi-level positive airway pressure (BiPAP) as well as emergent intubation. Furthermore, managing the ventilator settings in patients with an AECOPD is far from routine, requiring an intricate understanding of pulmonary physiology.3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this simulation, learners will be able to (1) assess for causes of severe shortness of breath, (2) manage severe COPD exacerbation by administering appropriate medications, (3) identify worsening clinical status and initiate NIPPV, (4) assess the causes of hypoxia after establishing endotracheal intubation and, (5) identify indication for needle decompression and perform chest tube thoracostomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This simulation was conducted with a high-fidelity mannequin with a separate low fidelity chest tube mannequin that allowed for hands-on practice placing a chest tube. A total of 16 PGY-1 residents participated in the simulated patient encounter.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;Following the simulation and debrief session, all residents were sent a Likert scale survey via surveymonkey.com to assess the educational quality of the simulation. The survey contained the following questions; 1) Overall, this simulation was realistic and could represent a patient presentation in the Emergency Department, 2) Overall, the case contained complexity that challenged me as a learner, 3) This case helped to expand my medical knowledge, 4) I feel more confident in diagnosing and treating AECOPD, 5) I feel more confident in recognizing the indications for NIPPV and intubation, 6) This simulation offered an opportunity to improve my procedural skills, 7) I feel more confident in setting up the ventilator, 8) I feel more confident in addressing ventilator alarms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following the simulation and debrief session, all the participants (n=16), were provided a survey to assess the educational quality of the simulation. There were a total of 12 respondents and a hundred percent of them agreed or strongly agreed that the case contained complexity that challenged them. All of the respondents agreed th","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836879","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 Man with Sore Throat-A Case Report.","authors":"Nathan Mercado,&nbsp;Sawyer Schuljak,&nbsp;Daniel Ng,&nbsp;Curtis Knight,&nbsp;Allison Woodall,&nbsp;John Costumbrado","doi":"10.21980/J8MH0B","DOIUrl":"https://doi.org/10.21980/J8MH0B","url":null,"abstract":"<p><p>Supraglottic thermal burns resulting from ingestion of excessively hot food or drink can potentially lead to fatal airway obstruction due to severe edema. In this case we evaluate an adult male who presented to the emergency department (ED) with sore throat and mild voice hoarseness that began while eating hot rice soup two days prior. The patient states that after taking a bite of the hot soup, he coughed due to the heat. Shortly after, he felt a burning sensation in his throat and developed a foreign body sensation. A visual examination with video laryngoscopy of the upper airway showed no evidence of foreign bodies; however, there were suspected thermal burns near the patient's epiglottis. This case demonstrates how thermal burns can be evaluated and treated with conservative measures to reduce edema, but care takers should be aware of the severe burns leading to complete airway obstruction.</p><p><strong>Topics: </strong>Supraglottic burns, airway obstruction, laryngoscopy.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827748","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}