See ourfluid prescribing guidefor more details onresuscitation fluids. Causes: Any situation arising in a diabetic that requires increased insulin without that demand being met can result in DKA. Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine Introduction Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most . We have been presenting Simulation Laboratory sessions to our preclinical medical students (first and second years). An individual student can get an immediate answer to a question, the facilitator can see puzzled expressions on faces, and the PBL group could get answers that they could not get during their prior PBL group discussions. You could also ask a student to smear a small amount of acetone on a piece of glass to see how volatile it is, helping them understand why its being exhaled by the DKA patient. The purpose of this simulation is to demonstrate the specific clinical signs of the patients with DKA, and the keys by which we recognize DKA in the early stages. Case-based simulation should include two to three broad-focus objectives, as well as 1020 specific performance measures that the student should accomplish. In the simulated environment, trainees will ask questions on how to interpret the data that they observe on the monitors and interpretation of clinical signs and symptoms on the manikin. - 150+ PDF OSCE Checklists: https://geekymedics.com/pdf-osce-checklists/ Conclusions This technical report describes the design and implementation of a simulation scenario on DKA for emergency medicine trainees. It involves a facilitating instructor, a small learner group and conceptual aspects of environmental and manikin staging to provide sensory cues. The main purpose of the simulation is to draw a line from the theoretical, boring biochemistry to the clinical manifestations. Each PBL case typically goes over 23 days, affording the students periods to find information for the case. One of the key differences with the immersive simulation is that the instructor is absent from the simulation environment. Simulation in Healthcare4(4):232-236, Winter 2009. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Refer to your local guidelines which should provide a clear protocol for the management of DKA. As a next step, we will let one of the trainees talk to the patient, and prompt to ask medical questions such as previous medical issues or recent drug use for them to practice asking questions to generate a differential diagnosis (in this case, other causes for confusion). The validity of the HFS-DKA scenario was verified by a certified diabetes nurse educator, a registered nurse, and a clinical nurse educator. Forty percent of respondents reported excessive daytime sleepiness. PBL was introduced at our institution in 1995. Medical simulation technology is a powerful tool for training physicians but papers dealing with DKA simulators are scarce. Prehosp Emerg Care. Yes: if the patient can talk, their airway is patent and you can move on to the assessment of breathing. 3 0 obj DIABETIC KETOACIDOSIS MODULE: ENDOCRINOLOGY / METABOLIC TARGET: ALL PAEDIATRIC TRAINEES;NURSING STAFF BACKGROUND: DKA occurs when a relative or absolute lack of insulin leads to the inability to metabolise glucose. Surgical dressings and imitation blood can support medical history. 1. Advance the airway until it lies within the pharynx. The consequences (low blood pressure, high heart rate, central nervous system status, etc.) A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. In an animated lecture, its important that the student group have an instructor so they can ask direct questions. Marx JA, Hockberger RS, Walls RM. We now provide the students with handouts of the data to save time and provide consistency. Typically potassium levels should be maintained between 4.0 5.5 mmol/L and close monitoring is required. During the debriefing process that follows the simulation, well-balanced performance measures will guide feedback toward accomplished tasks and may illustrate existing decision-making, behavioral or technical skill deficits. - Site 01:12 Antibiotics should be prescribed in keeping with local guidelines. Anesthetic Management Using the Oxygen Reserve Index for Tracheal Resection and Tracheal End-to-E A Scoping Review of the Impact of COVID-19 on Kidney Transplant Patients in the United States, Alabama College of Osteopathic Medicine Research, Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, DMIMS School of Epidemiology and Public Health, Simulation, Biodesign, & Innovation In Medical Education, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, VCOM Clinical, Biomedical, and Educational Research, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Medical Society of Delaware Academic Channel, Society for Healthcare & Research Development, Surgically Targeted Radiation Therapy for Brain Tumors: Clinical Case Review, Clinical and Economic Benefits of Autologous Epidermal Grafting, Defining Health in the Era of Value-Based Care, Optimization Strategies for Organ Donation and Utilization, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings. The facilitator guides the group only when necessary. Simulation Scenario. This is a 25-year-old woman with a medical history of diabetes medicated with 40 units insulin per day. PA EMT Said COVID Patient Didnt Need to Go to the Hospital. In some cases, normal saline with additional potassium is required to prevent overcorrection of serum potassium levels which would otherwise result in hypokalaemia. Section snippets . A simulation training session is described designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis through the use of simulation. x]o ]?9kgq~:)?hE )R6!up}\<8||\]}Y~;xp~yQ$#4~djX&{n_m-]^K1/~/AD Hv 99evs,;8}8zwnhFxV.kf-V^? endobj With your index and other fingers placed behind the angle of the mandible, apply steady upwards and forward pressure to lift the mandible. Please write a single word answer in lowercase (this is an anti-spam measure). Centers for Disease Control and Prevention. Available from: [, NICE guidelines. This environment doesnt allow the student to identify presentation cues, be active in their own learning or apply their skills without endangering the lives of patients.(2). - Over 3000 Free MCQs: https://geekyquiz.com/ Download: http://teamworkmatters.ocbmedia.com/media/DKA-Simulation-Scenario.docx Categories: 5th Year MBChB paeds scenario, Emergency Department, Human Factors, Interprofessional / multidisciplinary, Non-technical skills, Paediatrics, Postgraduate / newly qualified, Undergraduate / pre-registration Rating #geekymedics #fyp #fypviral #studytok #medicalstudentuk #medtok #studytips #studytipsforstudents #medstudentuk #premed #medschoolfinals, Cardiovascular History Tips - DON'T FORGET these 3 things . 2. This style also doesnt mimic an actual scene, and a student may feel that treatment modalities and skills are performed at a slower rate than real-world applications. DO NOT perform any examination or procedure on patients based purely on the content of these videos. The files are given in full in the web supplement (Appendix B, Supplemental Digital Content 2, https://links.lww.com/SIH/A2). Recognize the signs and symptoms of a patient presenting with diabetic ketoacidosis. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Virtual patient simulation (VPS) is an interactive computer simulation that recreates real-world scenarios with the objectives of training, education, and assessment for health care providers [].Virtual simulation has been used extensively to adapt nursing education to the COVID-19 pandemic context [], such as social distancing and/or confinement. However, this turned out to be too slow, took too much time, and could not continuously demonstrate the direction of changes. Keyword Highlighting They have had no clinical exposure or any clinical experience. Inspect theairwayfor obviousobstruction. . Inspect the urine currently in the catheter bag and note its appearance (e.g. Does the patient need reviewing by a specialist? KDCA, Ronald Reagan Washington National Airport, DC. The students have acquired all the applicable theoretical knowledge of the case during the previous multiday PBL sessions. Therefore, the session is divided into four sections of 15 minutes each, so that the facilitator is constantly aware of being on time (or not), even after the first 15 minutes period. - Medical Finals Question Pack: https://geekymedics.com/medical-student-finals-questions/ 1. The simulation session is also hosted as an interactive session. Finally, we summarize the course and give them time for questions. Trainee will increase knowledge of professional behaviors during the simulation. It involves working through the following steps: Each stage of the ABCDE approach involvesclinicalassessment,investigationsandinterventions. On the basis of the feedback from the students, they indicated that they believed the small group sessions are better. Simulation-based medical education: An ethical imperative. Introduction: Diabetic ketoacidosis (DKA) is a life-threatening illness which classically presents with polyuria, polydipsia, and polyphagia that can rapidly progress to severe dehydration and altered mental status from cerebral edema. Open the patients airwayusing ahead-tiltchin-lift manoeuvre: 1. As this is an interactive discussion session, any needed debriefing and/or explanation is given during the sessions. This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. If the provider starts an IV and gives dextrose, then the patients alertness will increase, respirations will normalize and repeated blood glucose will read 210 mg/dL over a two-minute interval. Measure the patients capillary blood glucose and ketone levels to confirm the diagnosis and guide the management of DKA. 2009;13:505511. 3. The instructor should have visual access via one-way windows or cameras. An events progression section should include patient status changes, as well as a time/treatment continuum that incorporates if-then event progressions. The instructions to the facilitators suggest a series of structured, sequential questions to the students (starting at one end, involving each student in turn, and repeatedly cycling around the group.) The faculty member/course coordinator of Simulation Design Available from: [. - Timing 03:23 5. Published August 2015. After entering the environment, the student doesnt have the option of leaving the simulation until the learning objectives and performance measures are achieved. Data Description All the product records are stored at /user/spark/dataset/retail_db/products All the category records are stored at /user/spark/dataset /ret. If foreign material is present, attempt removal using suction. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Invasive monitors, including a left radial intraarterial and a right subclavian IV catheter, were placed. I assigned true to life parking codes, and added some extra parking for the superfluous US Express AI. JEMS. Simulation Scenario for Anesthesia Providers Clark Obr, MD*, Anthony Mueller, MD . A hyperglycemic patient may present with tachypnea, which often presents as Kussmauls respirations, tachycardia, orthostatic blood pressure changes and other signs of dehydration and diabetic ketoacidosis (DKA). Groups of more than seven may struggle with meeting objectives due to insufficient functional rolls. Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. Simulation Scenario for Anesthesia Providers Clark Obr, MD*, Anthony Mueller, MD *Corresponding author: clark-obr@uiowa.edu Abstract Introduction: This simulation on diabetic ketoacidosis (DKA) in . Interactive lecture/discussion with use of monitors that show the vital signs of the simulated patient on manikin. Prehosp Emerg Care. 2008;6:278302. Emergency medical services workLife characteristics contribute to clinically significant excessive daytime sleepiness. }HyEf,#$/JSRU9+CF6k\'/z+i`[ 5JudK*Zly^g%[jCK)H[)Y=Qp0/r9o9HW_zF}pTzI~'|q.~:=Y T 9w! A well-staged environment allows for greater student buy-in. Perform urinalysis and send the urine for culture if urinary tract infection is suspected. Both external and internal potassium balances are disturbed during the development and treatment of DKA. There are several causes of DKA, which we remember by the "five I's". She is lethargic and slightly confused but can intermittently respond to questions. opioids, sedatives, anxiolytics, insulin, oral hypoglycaemic medications). Its important to train and educate students of prehospital care on key indicators of a diabetic emergency. J Nurs Educ. (1) According to Centers for Disease Control and Prevention (CDC), 223,619 deaths were attributed to diabetes in 2005. The HFS-DKA simulation teaching consisted of pre-briefing (an hour), running simulation (30 minutes) and debriefing (an hour) for the high-fidelity simulator using the Lardeal SIM man . We do not use passive visualizing materials such as videotapes or DVD other than vital signs shown on the monitors. Feel the slow and tardy pulse, we consider these PBL sessions as an example of a Look here, see this use of a full human simulator in the hierarchy of learning strategies with a full human simulator (Table 1). Cureus is on a mission to change the long-standing paradigm of medical publishing, where submitting research can be costly, complex and time-consuming. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. Twitter: http://www.twitter.com/geekymedics Trainee will be respectful to others and their views during the PBL session. Well done, youve now stabilised the patient and theyre doing much better. As individuals with uncontrolled type I . Over the years, some groups happened to have the simulation session before the completion of the theoretical PBL session. Refer to your local guidelines for further details. The researchers found that long shift hours (24hrs), working overtime and marital/relationship stress were strongly correlated. It was They should introduce the student group to the environment, assign roles for each learner and guide the decision-making process. An oxygen mask is also demonstrated as an alternative device, as these early trainees had mostly not yet seen any of these devices. Diabetic ketoacidosis (DKA) is a common, potentially lethal disease. See Table 4 for a suggested standardized script. Could we not just do this as a large group session to all 160 students (versus 20 1-hour sessions to groups of eight students)? The normal reference range for fasting plasma glucose is 4.0 5.8 mmol/l. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. This typically involves the use of anon-rebreathe maskwith an oxygen flow rate of15L. Trigger 4, Pathway 1l of saline required over 1hour and insulin infusion need prescribing and making up in 50ml syringe. The questionnaire for the assessment of the session is given in full in the web-based supplement (Appendix A, Supplemental Digital Content 1, https://links.lww.com/SIH/A1). - PSA Question Pack: https://geekymedics.com/psa-question-bank/ Nandate, Koichiro MD, PhD; Abola, Ramon MD; Murray, W Bosseau MB; Whitfield, Carol PhD; Lang, Charles PhD; Sinz, Elizabeth MD. Just place the BR2_KDCA file into your addons scenery folder: C:\\Program Files\\Microsoft Games\\Microsoft Flight Simulator X\\Addon Scenery\\Scenery. Acad Med. A blood glucose level may already be available from earlier investigations (e.g. If an obstruction is visible within the airway, use afingersweeporsuctionto remove it. Despite this increased calorie intake, she noticed an unexplained 20 lbs weight loss. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Alert a senior immediately if you have any concerns about the consciousness level of a patient. insulin-dependent type 2 diabetes), Altered consciousness (e.g. If fever is present, make sure to consider co-existing infection. Immersive Simulations Therefore, we should not have to take much time on this issue, but we have to focus on the relationship between the biochemistry and clinical signs and symptoms by asking why the patient is dehydrated, why acidosis develops, why respiration is rapid and deep (Kussmaul) respirations, and what the rationale for inpatient treatment is. 4. If the patient is suspected to have sufferedsignificanttraumawith potential spinal involvement, perform ajaw-thrustrather than a head-tilt chin-lift manoeuvre: 2. Using SOCRATES in History Taking | OSCE | Communication Skills, Diabetic Ketoacidosis (DKA) | Acute Management | ABCDE. The required potassium replacement varies greatly. Introduceyourselfto thepatientincluding yournameandrole. In the final 10 minutes, we show how the patient has a good recovery after fluid replacement. NPAs should not be used in patients who may have sustained a skull base fracture, due to the small but life-threatening risk of entering the cranial vault with the NPA. After the initial treatment is initiated, by showing a simulated urine and blood, and by getting them to smell ketones, we can enable the trainee to confirm the diagnosis of DKA. This allows us to get in touch for more details if required. Adds true to life parking codes and extra parking for AI. We combined both to indicate the continuity of the curriculum, and the building on prior knowledge. Because of the early stage (first year) of their medical careers, they have not yet seen vital sign monitoring, or patients, so these clinical aspects are introduced and emphasized. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel . Development of simulation scenarios for an adolescent patient with diabetic ketoacidosis. If any obstruction is encountered, remove the tube and try the left nostril. 2011;15:108109. The Simulation Laboratory session follows after a completed PBL session, and is aimed at making the case come alive, while providing a clinical perspective to preclinical students. 2010;49:578586. Topic: Abdominal TraumaTitle: Motorcycle CrashTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Adrenal CrisisTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: AnaphylaxisTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: AnaphylaxisTitle: Anaphylaxis In An InpatientTarget: PGY1Author / Institution: Alison Rodger, Babar Haroon / Dalhousie Universityclick here to download, Topic: AnaphylaxisTitle: Bee Sting In An 8 Month OldAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: ApneaTitle: Drowning In A 3 Year OldAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: Asthmatic Protocol for EDTitle: Branching Scenario: 3 Treatment Routine ER - Pediatric PatientTargets: Emergency Department Staff and Respiratory Therapy StudentsAuthor / Instituation: Carl Rod, MS, RRT, RCP, Rose State College RT Clinical Simulation Labclick here to download, Topic: Atrial FibrillationTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download plus chart documents here, Topic: Bidirectional Ventricular Tachycardia from Digoxin ToxicityTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: BradicadiaTitle: Bradycardic Arrest - Carotid Sinus MassTarget: PGY1Author / Institution: Babar Haroon / Dalhousie Universityclick here to download, Topic: BurnTitle: Cigarette FireTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: BurnTitle: Meth Lab Explosion Target: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Cardiac ArrestTarget: Inter-professional Team TrainingAuthor / Institution: Alim Nagji, Krista Dowhos / Joseph Brant Hospitalclick here to download, Topic: Chest and Abdominal TraumaTitle: Auto AccidentTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: CHF (Congestive Heart Failure)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Communication, Interpersonal Skills, Mediating Conflict Title: Managing Family Members with Different Views Target: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Crohns FlareTitle: Complicated CrohnsTarget: PGY1Author / Institution:Allen Tran / Dalhousie Universityclick here to download, Topic: Delirious, Combative / Violent Patient Management Title: DeliriumTarget: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Delivering Bad NewsTitle: Delivering Bad News after a StrokeTarget: ICU FellowsAuthor / Institution: Ryan Fink, Miko Enomoto / OHSUclick here to download, Topic: Difficult AirwayTitle: Ace Inhibitor AngioedemaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Difficult AirwayTitle: Difficult / Failed AirwayTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Disclosure of an Adverse EventTitle: Retained Guidewire from a Central LineTarget: ICU FellowsAuthor / Institution: Ryan Fink / OHSUclick here to download, Topic: DKA (Diabetic Ketoacidosis)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: DKATarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Dyspnea (Shortness of Breath)Title: Acute Pulmonary Edema requiring intubationTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Dyspnea (Shortness of Breath)Title: Severe Asthma requiring intubationTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Electrical StormTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download plus chart documents here, Topic: Emergent Med-Surg ResponseTitle: MET/RRT ResponseTargets: Response Teams, House Staff and Respiratory Therapy StudentsAuthor / Instituation: Carl Rod, MS, RRT, RCP, Rose State College RT Clinical Simulation Labclick here to download, Topic: EtOH WithdrawalTitle: EtOH Withdrawal SiezureTarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Febrile NeutropeniaTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Head TraumaTitle: Four Storey FallTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Head TraumaTitle: Hit by MotorboatTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: HypertensionTitle: Aortic DissectionTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: HypertensionTitle: Autonomic DysreflexiaTarget: Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: Hypertensive EmergencyTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Hypertensive EmergencyTitle: Diastolic Danger Hypertensive Urgency / EmergencyTarget: PGY1Author / Institution: Hailey Hobbs, Babar Haroon / Dalhousie Universityclick here to download, Topic: HypoxiaTarget: Inter-professional Team TrainingAuthor / Institution: Devin Sydorclick here to download, Topic: Inferior StemiTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Labor and delivery, postpartum hemorrhageTitle: Normal Delivery with PPHTarget: Maternal - Child Course - Nursing EducationAuthor / Institution: Kelly McMunnclick here to download, Topic: PEA Arrest (pulseless electrical activity)Target: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Pelvic FractureTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: Penetrating Thoracic TraumaTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: PneumoniaTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: PneumoniaTitle: Community Acquired PneumoniaTarget: PGY1Author / Institution: Iain Arseneau, Babar Haroon / Dalhousie Universityclick here to download, Topic: Pulmonary EmbolismTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Ruptured Ectopic PregnancyTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: SepsisTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: SepsisTitle: Sepsis - Crohn's IntraabdominalTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: SepsisTitle: Sepsis - DKA and PneumoniaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: SepsisTitle: Sepsis - Febrile NeutropeniaTarget: Mid - Senior Emergency ResidentsAuthor / Institution: Anonclick here to download, Topic: ShockTitle: Blunt Trauma Causing a High Spinal Cord Injury with Neurogenic ShockTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: ShockTitle: Hemorrhagic Shock in an Elderly Pedestrian stuck by a VehicleTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: ShockTitle: Penetrating Chest Trauma Causing Obstructive ShockTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Tim Chaplin, Alison Archibaldclick here to download, Topic: Snake BiteTarget: ER residentsAuthor / Institution: Katie Gordon / University of Maryland School of Medicineclick here to download, Topic: Status AsthmaticusTarget: PGY1Author / Institution: Unknownclick here to download, Topic: Status Epilepticus - Apnea Post-BenzodiazepinesTitle: Seven month old with Status EpilepticusTarget: Pediatric ResidentsAuthor / Institution: Keith Gregoireclick here to download, Topic: StrokeTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: Subdural Hemorrhage Title: SDH and DOACTarget: PGY1Author / Institution: Allen Tran / Dalhousie Universityclick here to download, Topic: Syncope / TorsadesTitle: Syncope / Torsades in the setting of acquired prolonged QTTarget: PGY1Author / Institution:Tasha Kulai, Babar Haroon / Dalhousie Universityclick here to download, Topic: Tachycardia Rapid AFTarget: PGY1Author / Institution: Allen Tran, Babar Haroon / Dalhousie Universityclick here to download, Topic: Toxic Shock SyndromeTarget: Senior Emergency Residents / Trauma TeamAuthor / Institution: Anonclick here to download, Topic: Toxicology - Bupivicaine OverdoseTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Toxicology - Hydrofluoric Acid BurnsTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Toxicology - OrganophosphatesTarget: Senior Emergency ResidentsAuthor / Institution: Queens Universityclick here to download, Topic: Upper GastrointestinalI BleedTarget: Internal MedicineAuthor / Institute: Jim Boseovski / Queen's Universityclick here to download, Topic: Upper Gastrointestinal BleedingTitle: GI BleedTarget: PGY1Author / Institution: Babar Haroon / Dalhousie Universityclick here to download, Topic: Viral bronchiolitis in infants requiring intubationTitle: Apnea in the infant with RSV bronchiolitisTarget: Pediatric ResidentsAuthor / Institution: Mike Storrclick here to download.

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