The patient is found by a friend unresponsive after a 7 day history of cough and shortness of breath. He immediately receives bystander CPR. An advanced care paramedic crew attends the scene and manages a ventricular fibrillation arrest prior to transporting to hospital. The patient goes into cardiac arrest again shortly before arriving in the emergency department. The team will need to prepare for the patient's arrival and then manage a cardiac arrest using appropriate precautions for suspected COVID-19.
Category: Uncategorized
Pediatric Airway Obstruction
This case involves an 8 year-old boy with upper airway obstruction from sausage. When indirect treatment fails, removal with Magill forceps under direct visualization is required. The patient slowly recovers after removal of foreign body but will require admission for monitoring.
COVID-19: Respiratory Failure
This case was designed during the January 2020 COVID-19 outbreak in order to assess and improve team preparedness for safely and effectively caring for a critically ill coronavirus patient from triage through to intubation.
Resuscitative Hysterotomy
The team receives advance notification from EMS about a 30 year-old female who is visibly pregnant and was in a car accident. Upon arrival to the ED the patient loses pulses and CPR begins. The team must begin ACLS/ATLS and proceed to resuscitative hysterotomy. After delivery they should begin neonatal resuscitation and continue management of the mother. Early consultation should be made to trauma surgery, NICU, and OB.
Nightmares Case 7: Hyperkalemia
This case involves the diagnosis and management of hyperkalemia. If not treated appropriately the patient will progress to ventricular fibrillation arrest.
Nightmares Case 5: Pulmonary Edema
This case involves the approach to the patient with acute dyspnea. The patient is tachypneic, hypoxic, and hypertensive. The team should consider multiple possibilities but recognize pulmonary edema as the most likely cause.
Nightmares Case 3: Seizure
The resident is called to the ward to manage a patient who may have had a seizure. The patient is somnolent when the resident arrives. Shortly afterward, the patient seizes again. Two doses of anti-epileptic will be required to terminate the seizure. Finally, when the patient has been stabilized, the resident will be required to discuss the case with their staff on call.
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Getting Serious about GridlockED: Lesson Plans to Teach about Systems Improvement
Written by Sonja Wakeling. Edited by Dr. Teresa Chan. Everything I know about ED management I learned from… A Board Game? GridlockED is an innovative board game that fosters teamwork, knowledge acquisition and application, and problem-solving skills. Developed by clinician educators and trainees, it was designed to simulate real-life settings in an emergency department within … Continue reading Getting Serious about GridlockED: Lesson Plans to Teach about Systems Improvement
Pregnant Cardiomyopathy
A 38-year-old female G2P1 at 36 weeks GA presents with acute on chronic respiratory distress in addition to chronic peripheral edema. She undergoes respiratory fatigue and hypoxia requiring intubation. She then becomes hypotensive which the team discovers is secondary to cardiogenic shock, requiring vasopressor infusion and consultation with Cardiology/ ICU.
EM Sim Cases 