The western journal of emergency medicine
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Comparative Study
Learning curves for direct laryngoscopy and GlideScope® video laryngoscopy in an emergency medicine residency.
Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program. ⋯ Over the course of residency training there was no significant improvement in EM resident first pass success with the DL, but substantial improvement with the GVL.
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Observational Study
Ultrasound-guided small vessel cannulation: long-axis approach is equivalent to short-axis in novice sonographers experienced with landmark-based cannulation.
Our primary objective was to describe the time to vessel penetration and difficulty of long-axis and short-axis approaches for ultrasound-guided small vessel penetration in novice sonographers experienced with landmark-based small vessel penetration. ⋯ Novice sonographers, highly proficient with peripheral IV cannulation, can perform after instruction ultrasound-guided small vessel penetration successfully with similar time to vessel penetration in either the long-axis or short-axis approach on phantom models.
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A "flipped classroom" educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. ⋯ Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents.
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Case Reports
Ultrasound-guided diagnosis and aspiration of subdeltoid abscess from heroin injection.
A 49-year-old man presented to the emergency department (ED) with shoulder pain after intramuscular injection of heroin into his right deltoid muscle. Point-of-care (POC) ultrasound identified a subdeltoid abscess, and ultrasound-guided aspiration of the fluid collection was performed. The patient was admitted and improved on antibiotics and made a complete recovery. POC ultrasound and ultrasound-guided aspiration can assist in the diagnosis and treatment of deep musculoskeletal abscesses.
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We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control. This case demonstrates the importance of the ED for infectious disease case identification and initiation of public health measures. This case also addresses public health implications of Chikungunya virus within the United States, and issues related to the potential for local spread and autochthonous cases.