25 year old male is involved in a boating accident. He was in the lake waterskiing and struck by another boat, sustaining blunt abdominal and pelvic injuries and significant propeller injuries to his leg. The trauma team will be activated and he will be brought to the ED. Treatment includes tourniquet application to the limb and rapid blood product administration. Intubation for clinical course and pain management need to be addressed with disposition to the operating room.
Tag: bleeding
PE with Bleeding
A 63-year-old female is in the Emergency Department awaiting internal medicine consultation for a diagnosed pulmonary embolism. She suddenly becomes very short of breath while walking to the bathroom and the team is called to assess. The patent will then arrest, necessitating thrombolysis. After ROSC, she will stabilize briefly but then develop increasing vasopressor requirements. The team will need to work through the shock differential diagnosis and recognize free fluid in the abdomen as a complication of thrombolysis requiring surgical consultation and transfusion.
EM Sim Cases 