This is the fourth case in a series looking at critical care medicine. A 59-year old man in your ICU was just extubated 30 minutes ago. He is four days post blunt polytrauma and has ongoing agitation but no other requirement for intubation. Since extubation, he has required several sedatives and has now developed stridor at rest.
Author: Chris Heyd
Organophosphate Poisoning
A 60-year old farmer presents to the ED with a runny nose, vomiting and diarrhea. He feels short of breath and dizzy. He looks so unwell that he is placed into the resuscitation bay. Initial vital sign show tachypnea, hypoxia, and bradycardia. You are immediately concerned about the copious nasal and oral secretions.
Critical Care 3 – Spinal Cord Injury
This is the third case in a series looking at critical care medicine. 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.
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.
Rapid Cycle Deliberate Practice
**July 28, 2025 - Scroll to the bottom for new rapid cycle case content** 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. A 57-year-old female with history of thymoma and myasthenia gravis is currently admitted to a general medical ward for pneumonia develops respiratory distress 48 hours after admission. A respiratory therapist (RT) was paged to assess the patient and then called you urgently because the patient appears unwell.
Critical Care 1 – Subarachnoid Hemorrhage
This is the first case in a series looking at critical care medicine. A previously healthy 46-year old woman is transferred from a surrounding hospital with CT-confirmed diagnosis of SAH with hydrocephalus. The patient is transferred direct to Neurosurgery and booked for OR but experiences progressive decreases in her GCS while awaiting surgery.
Massive Hemoptysis
This is a case of a breathless 57-year-old male coming into a community emergency department with symptoms consistent with COPD exacerbation. During his ED stay, however, the patient will develop massive hemoptysis with airway compromise, requiring learners to secure the airway, reverse anticoagulation, and manage massive hemoptysis.
Allyship: Gendered Microaggressions
This case aims to address microaggressions using simulation. It is not a traditional simulation case; in many ways, serves as a launching point for conversation.
Nightmares Case 12: Hypertensive Encephalopathy
This is the twelfth and final case in a series we are publishing that make up “The Nightmares Course” – a Sim Bootcamp for new residents. It is 3:00 am, you are called to the floor to assess a 73-year old man experiencing confusion, shortness of breath, and chest heaviness.
EM Sim Cases 