A 46-year-old woman pinned between truck and car has been resuscitated in ED and multiple injuries were identified, including bilateral rib fractures with flail chest, liver laceration and unstable T5-6 fractures with reduction of canal diameter. ICU has admitted the patient while she awaits OR later today to stabilize the spine.
Classic heat stroke
This case comes from Aneesha Thouli and Dr. Brad Stebner. Aneesha Thouli is a 4th-year medical student from the University of British Columbia. Dr Brad Stebner is a staff Emergency physician in Kelowna, BC, Clinical Instructor at UBC and one of our editors at EM Sim Cases. WHY IT MATTERS Classic heat stroke is a … Continue reading Classic heat stroke
Acetaminophen Overdose with an Uncooperative Patient
A 25-year old man presents to the emergency department after intentionally ingesting a significant amount of acetaminophen. He says that he was trying to kill himself and remains irritable and resistant to treatment.
Heat related illness
This case comes from Dr. Jared Baylis and Dr. Kelly Huang Dr. Baylis is the Simulation Medical Director at University of British Columbia - Southern Medical Program and Interior Health, as well as an editor of EM Sim Cases. Dr. Huang a PGY5 Emergency Medicine resident at University of British Columbia and is currently completing … Continue reading Heat related illness
LVAD Pump Thrombosis
A 70 y/o male post LVAD implantation presents to the emergency department with a chief complaint of shortness of the breath. The team will need to progress through the initial assessment of an LVAD patient, ultimately leading to a diagnosis of pump thrombosis. They will initiate anticoagulation, consult cardiothoracic surgery, and admit to CTICU.
Alcohol and opioid use
These cases come to us from Drs. Jessica Pelletier and Anne Ickes. Jessica Pelletier, DO is an Emergency Medicine Education Fellow at Washington University School of Medicine in St. Louis. Her interests include harm reduction, the use of simulation for difficult conversations and procedural preparedness, and the use of osteopathic manipulation for pain control in … Continue reading Alcohol and opioid use
Asthma in Pregnancy
A third trimester patient presents with a severe asthma exacerbation that deteriorates and requires BiPAP/ICU admission. The learner will need to identify severe asthma and manage accordingly accounting for differences in physiology during pregnancy.
Pediatric Drowning
A three-year-old child was swimming with their family, when they wandered into the deep end and submerged under water. The parents noticed the child was below the surface. When the child was brought to the surface, they were unconscious and coughing up foam. EHS arrived, provided oxygen supplementation, and brought them to your tertiary emergency department, with access to PICU. In the ED, the child is unconscious with increasing respiratory distress, requiring intubation. Despite intubation, the child remains hypoxemic and the team works through an approach to post-intubation hypoxemia. Unfortunately, the child becomes bradycardic. The team should begin CPR and follow the PALS pediatric bradycardia algorithm. PICU should be called if not already involved. After one round of CPR, the patient’s heart rate will increase and the consulting team should arrive.
Rapid Cycle Deliberate Practice
Rapid Cycle Deliberate Practice (RCDP) uses the theory of deliberate practice to create an environment in which skills building is accomplished through short cycles of simulation interrupted by micro-debriefing and followed by re-engagement in the simulation in order to “overlearn” the material.
Critical Care 2 – Myasthenic Crisis
This is the second case in a series looking at critical care medicine. Patients under the care of the critical care team may develop delayed complications of their illness or injuries. These cases can help individuals and teams prepare to identify and manage these patients who become newly, and sometimes unexpectedly, unstable. This case comes … Continue reading Critical Care 2 – Myasthenic Crisis
EM Sim Cases 