Journal of education & teaching in emergency medicine最新文献

{"title":"Managing STEMIs without a Catheterization Lab: A Simulated Scenario to Improve Emergency Clinician Recognition and Execution of Thrombolysis in the Setting of Rural STEMI Management.","authors":"Scott Schoenborn, Anthony F Steratore, Adam Hoffman, Thomas C Marshall, Erica B Shaver, Christopher S Kiefer","doi":"10.21980/J8K933","DOIUrl":"https://doi.org/10.21980/J8K933","url":null,"abstract":"<p><strong>Audience: </strong>The targeted audience for this simulation is Emergency Medicine (EM) residents. Medical students, advanced practice providers, and staff physicians could all also find educational merit in this scenario.</p><p><strong>Background: </strong>Cardiovascular disease is the leading cause of death in the United States according to the CDC.1 Coronary artery disease caused 375,000 deaths 2021 alone, and about 5% of all adult patients have a prior history of coronary artery disease.2 Furthermore, chest pain itself is a common chief complaint encountered in the ED, with nearly 8 million visits annually occurring throughout the United States, with 10-20% of those patients ultimately being diagnosed with an acute coronary syndrome3, including ST-elevation myocardial infarction (STEMI). Given this, it is essential that EM residents are well prepared to care for all patients presenting with chest pain, regardless of the acute care or emergency setting.Throughout their training, most EM residents typically learn and evaluate patients at a large tertiary or quaternary medical center with 24-hour catheterization laboratory availability. For patients presenting with electrocardiogram (EKG) findings consistent with STEMI, the standard of care is for the patient to undergo cardiac catheterization and stent placement within 90 minutes of arrival. Unfortunately, only half of patients living in rural areas have a cardiac catheterization-capable facility available to them within a 60-minute driving radius, making it difficult for those patients to undergo cardiac catheterization within the desired time frame.4 These patients remain candidates for thrombolytic therapy, but given infrequent opportunities to learn about and deploy thrombolytic agents during residency training, graduating EM residents may be unfamiliar with indications, dosing, and contraindications before they begin practice. Furthermore, the recent EM workforce data suggests that although there may be an oversupply of 8,000 emergency physicians by 2030, robust practice opportunities for emergency physicians remain in rural settings.5 Although historically EM graduates have not selected rural areas for practice, with only approximately 8% of emergency physicians practicing in rural areas,6 it is likely that given the opportunities present and perceived saturation in many non-rural settings, more EM graduates will pursue practice in a rural setting. With these changing practice dynamics in mind, this simulation provides the opportunity for residents and medical students to experience the management of a STEMI in the rural setting, with a focus upon the indications, contraindications, dosing, and disposition of a patient receiving thrombolytics.</p><p><strong>Educational objectives: </strong>By the end of this simulation, learners will be able to:Diagnose ST elevation myocardial infarction accurately and initiate thrombolysis in the rural setting without timely access to cardiac ","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 2","pages":"S55-S77"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11068321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874319","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":"Telescoping into Adulthood: A Case Report of Intussusception in an Adult Patient.","authors":"Neena Joy, Laura Kolster","doi":"10.21980/J8Q06C","DOIUrl":"https://doi.org/10.21980/J8Q06C","url":null,"abstract":"<p><p>Intussusception is a familiar diagnosis among the pediatric population; however, it is rarely considered among the adult population due to a myriad of life-threatening pathologies within the abdomen. We present an adult female who presented to the emergency department (ED) with abdominal pain and constipation. Laboratory testing and a computed tomography (CT) scan of the abdomen were ordered. Laboratory test results were notable for an elevated lymphocyte count as well as leukocyte esterase, white blood cells (WBC), and bacteria seen on urinalysis. The computed tomography scan detected a colo-colic intussusception secondary to a benign mass within the bowel lumen. The mass was surgically resected and the patient had an uneventful postoperative course. This unique case represents the occurrence of a pathology to which the adult population is not immune, and therefore should not be overlooked when evaluating a non-specific case of abdominal pain.</p><p><strong>Topics: </strong>Intussusception, colo-colic, obstruction, abdominal pain, constipation, female, mass, bowel, lymphocyte, ultrasound, computed tomography.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 2","pages":"V15-V17"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11068315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874320","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":"Septic Arthritis of the Acromioclavicular Joint: A Case Report.","authors":"Serena Tally, Michael Head, Kerri Kraft","doi":"10.21980/J8VP9N","DOIUrl":"https://doi.org/10.21980/J8VP9N","url":null,"abstract":"<p><p>Septic arthritis of native joints is uncommon, but the condition can be threatening to life and limb if left untreated.1 Septic arthritis of the acromioclavicular (AC) joint of the shoulder is particularly rare and has only appeared sparsely in medical literature, mainly through individual case reports. Early recognition and treatment of the condition is vital, but diagnosis of septic AC arthritis can be difficult due to its presentation with vague symptoms and nonspecific laboratory findings. This case report describes the care of a patient with poorly managed diabetes who presented to the emergency department with one month of pain and swelling of the left shoulder and two weeks of pain and swelling in the right ankle. Imaging revealed fluid in the AC joint, and laboratory evaluation showed an elevation in inflammatory markers, including leukocyte count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The patient's hospital course was complicated by methicillin-sensitive Staphylococcus Aureus bacteremia without evidence of sepsis. The patient underwent open debridement and washout of both the ankle and AC joint without complication. After recovery, the patient was discharged to a rehabilitative center with IV antibiotics and weekly follow up care with infectious disease specialists. This case illustrates the importance of early diagnosis and treatment of septic arthritis, even in less common joint spaces, to prevent progression of this dangerous disease.</p><p><strong>Topics: </strong>Septic arthritis, acromioclavicular joint, diabetes, bacteremia.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"V9-V14"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725208","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":"An Appy That Needs Epi: An Atypical Presentation of Anaphylaxis.","authors":"Ryan O'Neill, Cyrus Adeli, Christopher E San Miguel","doi":"10.21980/J80H14","DOIUrl":"https://doi.org/10.21980/J80H14","url":null,"abstract":"<p><strong>Audience: </strong>This simulation is intended for 4^th year medical students.</p><p><strong>Background: </strong>Shock is the result of inadequate circulation and failure to perfuse tissues, leading to cellular and organ dysfunction.1 Anaphylactic shock specifically is a type of distributive shock secondary to an IgE (immunoglobulin E) dependent reaction, which can result in respiratory compromise and cardiovascular collapse. The National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network (NIAID/FAAN) laid out three diagnostic criteria for the diagnosis of anaphylaxis. Fulfillment of any one of the three following criteria likely indicates anaphylaxis: 1) acute onset of illness with skin findings and either respiratory compromise or reduced blood pressure, 2) involvement of two or more organ systems after exposure to a likely allergen, 3) reduced blood pressure after exposure to a known allergen.2 While not a required component of the pathology, hives and cutaneous findings often prompt clinicians to consider anaphylaxis in their differential diagnosis. However, skin findings are absent in 10-20% of cases of anaphylaxis.3 It is therefore important for physicians to quickly recognize anaphylactic shock and begin appropriate management in a timely manner even in the absence of skin findings. A previous study of fatal anaphylactic reactions showed a median time to respiratory or cardiac arrest as 30 minutes for foods, 15 minutes for envenomations, and five minutes for iatrogenic reactions.4 Drugs are the most common reported cause of fatal anaphylaxis in the United States,5 and penicillin allergy is the most common drug allergy reported by patients.6 This simulation will help learners recognize an atypical presentation of anaphylactic shock, encourage them to consider anaphylaxis in their differential diagnosis for decompensated patients, and reinforce the correct management of anaphylaxis.</p><p><strong>Educational objectives: </strong>At the conclusion of the simulation, learners will be able to: 1) demonstrate ability to efficiently review patient records to optimize patient care and identify relevant details to current presentation, 2) rapidly assess a patient when there is a change in clinical status, 3) recognize the need to start resuscitative fluids for undifferentiated hypotension, 4) identify anaphylaxis, 5) demonstrate the medical management of anaphylaxis, 6) utilize the I-PASS framework to communicate with the inpatient team during the transition of care.</p><p><strong>Educational methods: </strong>This summative simulation was designed to assess competence in two of the core Entrustable Professional Activities (EPAs), as defined by the Association of American Medical Colleges (AAMC). These include EPA 8 (Give or Receive a Patient Handover to Transition Care Responsibility) and EPA 10 (Recognize a Patient Requiring Urgent or Emergent Care and Initiate Evaluation and Management). It wa","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"S1-S41"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725204","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 Clue is in the Eyes. A Case Report of Internuclear Ophthalmoplegia.","authors":"Cooper Nickels, Christy Keyes, Caroline Astemborski, Haley Fulton","doi":"10.21980/J8DP9M","DOIUrl":"https://doi.org/10.21980/J8DP9M","url":null,"abstract":"<p><p>The chief complaint of vertiginous symptoms can be daunting, and the differential is quite long. Approximately 15% of patients presenting to the emergency department (ED) with dizziness have a dangerous underlying cause.1 We present a case of a 40-year-old female with a sudden onset of what she describes as vertigo, in the setting of intermittent diplopia. The patient was found to have a left medial rectus palsy consistent with a left internuclear ophthalmoplegia. Internuclear ophthalmoplegia (INO) is an abnormal gaze that is characterized by the weakness or inability to adduct the affected eye. This occurs secondary to a lesion in the brain affecting the medial longitudinal fasciculus (MLF) most commonly in the pons; however, this pathway can also be affected in the midbrain.2 The diagnosis in our patient was confirmed after an MRI revealed an acute infarct of the left dorsal pons involving the medial longitudinal fasciculus, resulting in the observed left INO. The patient was admitted to the hospitalist service with neurology consultation for further stroke workup. Ultimately, the stroke was deemed cryptogenic in etiology with hyperlipidemia and obesity as the patient's risk factors. She was discharged home after three days in the hospital on daily aspirin and high-intensity statin. Upon six-month follow up she had near resolution of her symptoms.</p><p><strong>Topics: </strong>Internuclear Ophthalmoplegia, INO, Vertigo, Stroke, Neurology.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"V1-V8"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725209","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 a Child with Colocolic Intussusception with a Primary Lead Point.","authors":"Ethan Lee, Jeremy Lins, Chelsea Cosand, Mary Jane Piroutek, Tommy Y Kim","doi":"10.21980/J8564Q","DOIUrl":"https://doi.org/10.21980/J8564Q","url":null,"abstract":"<p><p>Intussusception is the telescoping of bowel into an adjacent segment of bowel and has an associated risk for bowel ischemia and perforation. The classic triad of abdominal pain, blood in stool, and an abdominal mass is present in less than 40% of pediatric cases and is less common in older children.1 Ultrasound has a high sensitivity and specificity for the diagnosis of intussusception, and once diagnosed, treatment modalities include reduction by either ultrasound or fluoroscopic guided air or hydrostatic enema. The risk of recurrence after successful reduction occurs in up to 12% of pediatric patients and occurs more frequently in older children and children with a pathologic lead point.2 We present a case of a 6-year-old child with colocolic intussusception that was successfully reduced and recurred within five days due to a large colonic polyp.</p><p><strong>Topics: </strong>Intussusception, lead point, pediatrics.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"V15-V18"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725206","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 Novel Leadership Curriculum for Emergency Medicine Residents.","authors":"Michael J Zdradzinski, Stephen Sanders, Qasim Kazmi, Vanessa Fields, James O'Shea, Sar Medoff","doi":"10.21980/J81D2S","DOIUrl":"https://doi.org/10.21980/J81D2S","url":null,"abstract":"<p><strong>Audience and type of curriculum: </strong>This longitudinal leadership curriculum is designed for emergency medicine residents at all levels, with individual sessions designed for each residency year.</p><p><strong>Length of curriculum: </strong>This curriculum runs once annually over three to four years of emergency medicine residency.</p><p><strong>Introduction: </strong>Leadership is a vital skill for emergency physicians but is often passively taught during residency training. Strong leadership skills can lead to improved patient outcomes, but very few residency programs in any specialty and no emergency medicine residency programs have published comprehensive leadership training curricula.</p><p><strong>Educational goals: </strong>The goals of this curriculum are to expose Emergency Medicine residents to the basics of leadership, to provide a graduated series of interactive, psychologically safe environments to explore individual leadership styles, to review interesting relevant literature, and to discuss leadership principles and experiences with senior leaders in our Emergency Department.</p><p><strong>Educational methods: </strong>The educational strategies used in this curriculum include: brief lecture-style seminars, small group discussion and reflection, and a panel-style discussion.</p><p><strong>Research methods: </strong>The educational content of this curriculum was evaluated by learners via feedback surveys after each session.</p><p><strong>Results: </strong>Course evaluations conducted in both 2017 and 2020 showed that more than 89% of resident participants found these sessions \"useful\" or \"very useful.\" All residents surveyed agreed that leadership is an important topic for emergency medicine residency, and 76% felt that the inclusion of leadership content strengthened the residency's curriculum. Suggestions for future topics included handling personal conflict and discussing transitions in leadership during yearly residency promotions.</p><p><strong>Discussion: </strong>The curriculum has been successfully implemented for seven years. It has proven to be sustainable and requires minimal resources. The residents report high satisfaction with the curriculum and agree that formal instruction on the topic of leadership is important to their on-shift performance and careers.</p><p><strong>Topics: </strong>Leadership, communication.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"C1-C15"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725203","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":"E-FAST Ultrasound Training Curriculum for Prehospital Emergency Medical Service (EMS) Clinicians.","authors":"Clever M Nguyen, Krista Hartmann, Craig Goodmurphy, Avram Flamm","doi":"10.21980/J8S060","DOIUrl":"https://doi.org/10.21980/J8S060","url":null,"abstract":"<p><strong>Audience and type of curriculum: </strong>Audience and type of curriculum: This hybrid, asynchronous curriculum is designed for prehospital clinician colleagues, including but not limited to emergency medical technicians (EMT), advanced EMTs (AEMT), EMT-paramedics (EMT-P), critical care EMT-Ps (CCEMTP), critical care transport nurses (CCTN), and certified flight registered nurses (CFRN) to learn and practice ultrasound fundamentals in the setting of a standardized extended focused assessment with sonography in trauma (E-FAST) exam.</p><p><strong>Length of curriculum: </strong>Over a five-month curriculum, learners will perform a pre-test, review online module lectures, attend an ultrasound scanning workshop, and perform post-test examinations.</p><p><strong>Introduction: </strong>The extended-focused assessment with sonography in trauma (E-FAST) exam can identify intrathoracic and intraabdominal free fluid, as well as pneumothoraces. The E-FAST ultrasound exam has previously been taught to clinicians of various backgrounds in healthcare including emergency medical service (EMS). However, an open-access, systemized curriculum for teaching E-FAST exams to EMS clinicians has not been published.</p><p><strong>Educational goals: </strong>By the end of these training activities, prehospital EMS learners will be able to demonstrate foundational ultrasound skills in scanning, interpretation, and artifact recognition by identifying pertinent organs and anatomically relevant structures for an E-FAST examination. Learners will differentiate between normal and pathologic E-FAST ultrasound images by identifying the presence of free fluid and lung sliding. Learners will also explain the clinical significance and application of detecting free fluid during an E-FAST scan.</p><p><strong>Educational methods: </strong>The educational strategies used in this curriculum include a hybrid, asynchronous curriculum encompassing 2.5 hours of lectures derived from online learning modules and in-person review. In addition, learners will attend 2 hours of hands-on proctored ultrasound scanning practicing E-FAST examinations.</p><p><strong>Research methods: </strong>An online 13-question pre-test was administered prior to the study. An online post-test and in-person scanning OSCEs were administered at least eight weeks after their scheduled workshop consisting of an online 13-question multiple-choice post-test, a confidence survey, and a hands-on E-FAST Objectively Structured Clinical Exam (OSCE) session. A non-parametric Wilcoxon signed-rank test was performed between each pre-test and post-test metric to examine the statistical differences of paired data.</p><p><strong>Results: </strong>Post-test scores demonstrated statistically significant improvement in both image interpretation exams and ultrasound self-efficacy from the pre-test. The mean pre-test and post-test scores were 55.46% (7.21 ± 1.99) and 84.23% (10.89 ± 1.59) correct out of 13 questions, respective","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"C41-C97"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725207","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 Guide to the Medical School Curriculum Vitae.","authors":"Konnor Davis, Megan Boysen-Osborn, Alisa Wray, Lauren Stokes","doi":"10.21980/J8HH1S","DOIUrl":"https://doi.org/10.21980/J8HH1S","url":null,"abstract":"<p><strong>Audience: </strong>Although this lecture is aimed at medical students, it can also be utilized for residents, fellows, and junior faculty.</p><p><strong>Background: </strong>The topic of teaching medical students about the fundamentals of creating a curriculum vitae (CV) is important because a CV serves as a record of scholastic and professional experiences.1 Thus, their CV will undoubtedly play a vital role in residency applications.2,3 Intentional instruction about the elements to incorporate in a CV are especially important for first-generation and underrepresented students in the medical field because they may not have had as much exposure to both the requirements of a residency application nor qualities of an effective CV.</p><p><strong>Educational objectives: </strong>After this lecture, learners should be able to: 1) elaborate on the significance of a CV for medical students and discuss its purpose, 2) outline the elements that should and should not be included on a CV, 3) integrate knowledge gleaned from basic principles with provided examples to establish the foundation of their own CV.</p><p><strong>Educational methods: </strong>A PowerPoint lecture was used to explain the purpose of a CV and the elements to include in a personal CV for medical students. The lecture took place via Zoom and was provided at no cost to all UCISOM medical students.</p><p><strong>Research methods: </strong>Students were given a short survey after the session to assess their understanding of why it is important to create and maintain a CV, including an evaluation of their overall satisfaction with the lecture presentation.</p><p><strong>Results: </strong>All the respondents (n=10) found the workshop to be useful and enjoyed the ability to see student examples while 80% of the respondents (n=8) found their knowledge of CVs increased because of the session. On a Likert scale from 1-5, with a 1 indicating \"very unconfident\" and 5 indicating \"very confident,\" 90% of respondents (n=9) indicated they are now confident or very confident in building or updating their CV after this session.</p><p><strong>Discussion: </strong>Overall, the educational content was found to be effective. Although the sample size from the survey was modest at best, we feel the survey data and comments from attendees during and after the session indicate the effectiveness of the content. From its initial implementation, we learned that this lecture can be given by any level of medical education professional (student, administrator, etc) due to the comprehensiveness of the presentation. We also learned that using video conferencing such as Zoom was an effective administration method but could also be replaced by in-person learning without much difficulty. Overall, we deem this presentation to be easy to administer, thorough, full of examples, and educationally effective.</p><p><strong>Topics: </strong>Curriculum vitae, CV, medical student, residency application, electronic residen","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"L1-L20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725202","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":"Calcium Channel Blocker Overdose.","authors":"Jessica G Andrusaitis, Alan Givertz","doi":"10.21980/J8CQ07","DOIUrl":"https://doi.org/10.21980/J8CQ07","url":null,"abstract":"<p><strong>Audience: </strong>Emergency medicine residents and medical students on emergency medicine rotation.</p><p><strong>Background: </strong>Calcium channel blocker (CCB) overdoses can be severe with potentially serious adverse outcomes. CCBs work by blocking the calcium channels on smooth and cardiac muscle tissue. At low dose ranges, dihydropyridine CCBs (such as nifedipine, amlodipine, and nicardipine) block the L-type calcium receptors in the peripheral vasculature, whereas non-dihydropyridine CCBs (such as: verapamil and diltiazem) affect the L-type calcium receptors in the myocardium.1 Because of this distinction, dihydropyridine CCB toxicity manifests as arterial vasodilation and non-dihydropyridine CCB toxicity is associated with cardiac manifestations such as bradycardia and negative inotropy.2 It is important to note that in high concentrations (such as in overdoses), CCBs lose specificity for their specific receptors and can show all the manifestations of toxicity such as bradycardia, peripheral vasodilation, and hypotension. Patients can develop both vasoplegic shock from peripheral vasodilation and cardiogenic shock. This is a high acuity low occurrence case with infrequently used but specific treatments, and thus this case provides educational value.</p><p><strong>Educational objectives: </strong>At the end of this oral board session, examinees will: (1) demonstrate ability to evaluate a patient with undifferentiated shock with bradycardia and discuss the differential diagnosis, (2) recognize the signs and symptoms of calcium channel blocker overdose, (3) demonstrate ability to manage treatment of a patient with calcium channel overdose.</p><p><strong>Educational methods: </strong>This oral board case followed the standard American Board of Emergency Medicine-style case in a tertiary care hospital with access to all specialists and resources needed. 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 residency program.</p><p><strong>Research methods: </strong>Immediate feedback was solicited both from the learners and from the evaluators following the debriefing session. Residents were asked to evaluate the educational value of the case using a 1-5 Likert scale (5 being excellent). Evaluators were asked to score the residents using the ACGME core competencies with a scale of 1-8, 1-4 being unacceptable and 5-8 being acceptable.</p><p><strong>Results: </strong>Seven PGY1 residents and five PGY2 residents, thus twelve residents in total, completed the case. The average score was 5.10/8. Three residents missed zero critical actions. The most common critical action missed was consulting cardiology or cardiothoracic surgery for circulatory support options. Many residents failed to recognize that the patient did not have a perfusing blood pressure at the beginning of the case and did not start CPR. Although most reside","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"O1-O25"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725205","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}