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Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario - 700+ OSCE Stations: https://geekymedics.com/osce-stations/ In the final 10 minutes, we show how the patient has a good recovery after fluid replacement. Simulation of Diabetic Ketoacidosis for Cellular and Molecul DKA can be caused by either: Absolute insulin deficiency (e.g. 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. COVID-19 Screening in the Pediatric Emergency Department. 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. (1) The assessment of a diabetic patient is best taught as a. Trainee will recognize and interpret the clinical signs and symptoms and the typical history of a patient with DKA, as well as understand the major causative factors of DKA. PA EMT Said COVID Patient Didnt Need to Go to the NYC Unions Demand Reinstatement, Back Pay for Workers Fired for Refusing President Biden to End COVID-19 Emergencies on May 11. Initially, we required the students to write down the vital signs. Trigger 4, Pathway 1l of saline required over 1hour and insulin infusion need prescribing and making up in 50ml syringe. insulin-dependent type 2 diabetes), Altered consciousness (e.g. See ourfluid prescribing guidefor more details onresuscitation fluids. During an immersive simulation, its imperative the group uses critical-thinking skills and group collaboration independently. Animated lectures, however, must work within the framework of a focused case study, which requires increased preparation time. Instagram: https://instagram.com/geekymedics Experience has shown that the more experienced the provider, the more detailed the environmental and manikin staging should be, because providers are trained to take in and interpret visual cues as indicators of patient status. 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. Vital Signs: BP, 90/30 mm Hg (ECG shows normal sinus rhythm); central venous pressure, 0 to 2 cm H. Lungs: All lung fields are clear to auscultation without wheeze or rhonchi, and the respiratory pattern is typical of Kussmaul breathing, ie, large deep tidal volumes and increased respiratory rate. CCA 175 Real Time Exam Scenario 17 | JOIN Multiple DataFrames | Save as See ourhistory taking guidesfor more details. 1 0 obj Over the years, some groups happened to have the simulation session before the completion of the theoretical PBL session. However, we should not spend too much time on (not become distracted with) explaining unfamiliar monitors for the present trainees, such as central venous pressure or ETCO2 concentration. A strong emphasis is placed on the focused, methodical examination of a specific medical problem and the decision-based treatment options available. Target Learner Groups An arterial blood gas (ABG) can provide lots of useful information to guide management including: A chest X-ray may be indicated if abnormalities are noted on auscultation (e.g. This is particularly important for core . A traditional classroom lecture format allows for student participation but limits the instructors ability to create realistic situations. Diabetic Ketoacidosis in the Obstetric Population: A Simulation PA EMT Said COVID Patient Didnt Need to Go to the Hospital. Askhow the patient is feeling as this may provide some useful information about their current symptoms. An hour was . 2010;49:578586. Ask for anotherclinicalmemberofstafftoassistyou if possible. An integral part of a PBL session is for trainees to be able to navigate through huge literature bases. Trainee will be able to apply skills of communication with the simulated patient in a semiacute crisis to get sufficient important information for a final diagnosis. Conclusion: Our DKA simulator is a new tool whose objective is the training in a severe, frequent and complex situation, and can be used to improve the approach made by the junior physicians to the real diabetic . MassBay EMS Program Integrates Training for Dogs, Heat Waves Are Killing More LA Homeless People. Maintain head-tilt chin-lift or jaw thrust and assess the patency of the patients airway by looking, listening and feeling for signs of breathing. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. Blood sugar issues in the Type II diabetic will have a gradual onset, with diagnosis generally resulting from routine laboratory exams.(1). Please note that by doing so you agree to be added to our monthly email newsletter distribution list. She tends to drink sugar containing fluids (soda) when she is thirsty, and she eats fast foods (cream-filled muffins) when she is hungry. After initial insulin therapy has reduced plasma blood glucose levels (e.g. 2. At the end of the previous section, the trainee can make the diagnosis of DKA but has not confirmed it yet. Trainee will get to know how professionals behave during management of a critically ill patient. PBL was introduced at our institution in 1995. The required potassium replacement varies greatly. TheABCDEapproach can be used to perform a systematic assessment of a critically unwell patient. Advance the airway until it lies within the pharynx. Hypothermia may be present if the patient has been unconscious and exposed for some time. Assessment & Treatment of Five Diabetic Emergencies - JEMS Questionswhich may need to be considered include: The next team of doctors on shift should bemade awareof any patient in their department who hasrecently deteriorated. www.cdc.gov/diabetes/statistics/prev/national/. A pre-briefing session is conducted prior to the start of the simulation scenario. <>>> The students are in their first year. . NPAs are typically better tolerated in patients who are partly or fully conscious compared to oropharyngeal airways. Trainee will recognize the need for therapy and suggest an appropriate therapy in a simulated environment. In this section, we have to help the trainee to institute definitive therapy based on the underlying biochemical abnormalities. Groups of fewer than four students dont allow for optimal collaboration. >> Patterson PD, Weaver M, Frank R, et al. The normal reference range for fasting plasma glucose is 4.0 5.8 mmol/l. The simulation session is also hosted as an interactive session. %PDF-1.5 In an animated lecture, its important that the student group have an instructor so they can ask direct questions. angioedema, rash) commence appropriate treatment as discussed in ouranaphylaxis guide. The simulators do not have rock steady vital sign values, and the students were unsure as to write down 121 or 122 mm Hg as the systolic blood pressure. Makeup may be used to depict gender, hollow eyes and cheeks, produce pallor or display bruises and scars. They should introduce the student group to the environment, assign roles for each learner and guide the decision-making process. Inspect the urine currently in the catheter bag and note its appearance (e.g. endobj Catheterisethe patient to closelymonitor urine outputto guide fluid resuscitation and need for escalation. The Pratcice PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. For diabetic assessment involving DKA, staging may include the use of a container with a small amount of acetone placed near the manikin because many students may not know what acetone smells like but will expect to smell something. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Introduceyourselfto thepatientincluding yournameandrole. Facilitator to ask how often to measure BMs - Medical Finals Question Pack: https://geekymedics.com/medical-student-finals-questions/ - Exacerbating & relieving factors 05:12 Subscribe to our newsletter to be the first to know about our latest content: https://geekymedics.com/newsletter/ Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, most common in patients with type 1 diabetes in particular due to a deficiency or absence of insulin [1].. By joining Cureus, you agree to our Categories: Emergency Medicine, Medical Education Keywords: diabetic ketoacidosis, simulation, expertise, emergency medicine . 3. Pediatric Emergency Medicine Didactics and Simulation (PEMDAS If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. The researchers found that long shift hours (24hrs), working overtime and marital/relationship stress were strongly correlated. Causes: Any situation arising in a diabetic that requires increased insulin without that demand being met can result in DKA. Below is a collection of donated scenarios for you to use or modify. Trainee will appropriately request assistance and use available resources. 5. In some cases, normal saline with additional potassium is required to prevent overcorrection of serum potassium levels which would otherwise result in hypokalaemia. Prior to starting the scenario, the instructor should introduce a short summary of the case study and ask open-ended questions regarding the management direction. 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). We demonstrate to the trainees the significant changes on the monitors by asking them to point out any changes on the simulator (clinical examination) and the vital signs (monitor parameters). Effectiveness of simulation on health profession students knowledge, skills, confidence and satisfaction. 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. Highlight selected keywords in the article text. PDF Medicine Simulation Scenario Diabetic Ketoacidosis: An Emergency - Cureus Airway adjuncts are often helpful and in some cases essential to maintain a patients airway. - Examples 05:45 DKA can develop within 24 hours and is potentially life threatening, requiring prompt recognition and therapeutic intervention. (1) According to Centers for Disease Control and Prevention (CDC), 223,619 deaths were attributed to diabetes in 2005. JEMS. If you have any scenarios you would be willing to share with the simulation community, please forward them to me. dq-]gX4 `L'u7myx) rpjf0z,.y`VMyx-&Ju`U0 Section snippets . Recognize the signs and symptoms of a patient presenting with diabetic ketoacidosis. PDF Diabetic Ketoacidosis in the Obstetric Population: A Simulation Just place the BR2_KDCA file into your addons scenery folder: C:\\Program Files\\Microsoft Games\\Microsoft Flight Simulator X\\Addon Scenery\\Scenery. unilateral coarse crackles may be present if the patient has pneumonia which may have been the precipitant for DKA). DONT FORGET these 3 key components of the cardiovascular exam for your upcoming OSCEs Save this video to watch later and dont forget to follow Geeky Medics! See ourCXR interpretation guidefor more details. The DKA simulation incorporates cue recognition, analysis of cues, generation of solutions, nursing interventions, and evaluation of outcomes, including effective communication and psychosocial concerns. Some manikin models support a variety of human functions, such as capillary and facial cyanosis, facial sweating, foley catheter and IV placement, blood pressure generation, cardiac rhythms and abnormalities, defibrillation, cardioversion, external pacing and vital sign generation. >> Fernandez AR, Mac Crawford J, Pennell ML, et al. Insert at least onewide-bore intravenous cannula(14G or 16G) and take blood tests as discussed below. Diabetic Ketoacidosis (DKA) | Acute Management | ABCDE 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. Note that if-thens must also include negative patient outcomes for when the provider doesnt take appropriate action. Outcomes Educating Nursing Students Using an Evolving, Simulated Case Tilt the forehead back whilst lifting the chin forwards to extend the neck. Capillary refill timemay be prolonged if the patient is hypovolaemic. - Introduction 00:00 Open the patients mouth to ensure there is no foreign material that may be pushed into the larynx. Introduction: This simulation on diabetic ketoacidosis (DKA) in the obstetric population presents learners with one of the more commonly encountered etiologies of critical illness in the pregnant patient. 2 0 obj Clearly communicate how often would you like the patients observations relayed to you by other staff members. Revisit history taking to explore relevant medical history and identify any precipitating factors for DKA. However, this turned out to be too slow, took too much time, and could not continuously demonstrate the direction of changes. type 1 diabetes), Complete insulin insensitivity (e.g. The learning objectives follow the American College of Graduate Medical Education (ACGME) Core Compentencies. The Theory As this is a value-added session that demonstrates new concepts, such as the vital signs on a clinical monitor, there are no assessment instruments to measure gaining of understanding. - 2500+ OSCE Flashcards: https://geekymedics.com/osce-flashcards/ We have 18 to 20 PBL groups for an hour each in the week after their PBL DKA session. This session provides additional clinical support material for the theoretical PBL session. Her medical, social, and family histories are not clear at the time of admission to the emergency department. Make sure tore-assessthe patient after anyintervention. It was developed for anesthesiology resident physicians with some background knowledge and experience caring for critically ill patients. We then start the DKA state. See Appendix D, Supplemental Digital Content 4, https://links.lww.com/SIH/A4. Performing an ECG should not delay the emergency management of DKA. Place one hand on the patients forehead and the other under the chin. After the first voluntary session in 2006, feedback from the medical students indicated that they would like to receive this handout. Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department Medical simulation technology is a powerful tool for training physicians but papers dealing with DKA simulators are scarce. In this section, we have to guide them as to what they should do first for the patient in this critical condition (ie, treat the A, B, Cs of airway, breathing, and circulation) before we can confirm the diagnosis. Deteriorationshould be recognised quickly and acted upon immediately. your express consent. Trainee will correlate the underlying pathophysiology with symptoms and signs as exhibited by the simulation session. Trainee will be respectful to others and their views during the PBL session. stream Refer to your local guidelines for further details. See our blood glucose measurement guide for more details. Many of the preclinical students have never seen a real life clinical monitor or even an intravenous (IV) setup. Initially, we had a white board available, but the temptation (and habits) were just too strong, and the simulator sessions tended to become one way lectures, rather than an interactive, 2 way discussion.. VbQuX#R M21 When erroneous treatment is delivered, the instructor can end the simulation. Given such a small group, the students indicated that they feel more involved than they would with a larger group (eg, the whole class.) There are several causes of DKA, which we remember by the "five I's". Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. The teaching of diabetic assessment and management, like many other medical emergencies, lends itself well to case-based simulation. Development of simulation scenarios for an adolescent patient with diabetic ketoacidosis. It should only be inserted in unconscious patients as it is otherwise poorly tolerated and may induce gagging and aspiration. You may be asked to review a patient with DKA due to confusion, reduced level of consciousness, tachycardia, hypotension and/or vomiting. Immersive Simulations 2. KDCA for FSX - Fly Away Simulation Each performance measure is separated into cognitive, behavioral or technical categories. Wolters Kluwer Health A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Weight, Height: Not given, normal appearing (as per simulator) but has lost 20 lbs recently. - Site 01:12 Review the patients drug chart for medications which may cause a reduced level of consciousness (e.g. An animated lecture may be described as a pseudo-simulation environment. reduced air entry, coarse crackles) to screen for evidence of pneumonia. SimMan Nursing Scenarios Software - laerdal.com 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). Diabetic Ketoacidosis (DKA) Clinical Pathway Emergency Department | Children's Hospital of Philadelphia Data is temporarily unavailable. Other details are also important, including descriptions regarding patient language skill, social history, socioeconomic history, family history, religious practices or beliefs pertinent to treatment, and descriptive signs and symptoms. His Wife Gave Him CPR. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> DOI 10.7759/cureus.1286. Extremities: mild cyanosis, no clubbing or edema (verbalized by instructors); pulses equal, and symmetrical (elucidated by trainees). The learning environment should closely mimic real-world applications. DO NOT perform any examination or procedure on patients based purely on the content of these videos. endobj Its best, however, to allow the student group to continue so theyre able to evaluate their decision-making processes during debriefing. ABG, venepuncture). A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. to below 12 mmol/L) an infusion containing normal saline and 5% dextrose is typically commenced to prevent the development of hypoglycaemia, whilst allowing insulin therapy to continue to suppress ketogenesis and reduce serum electrolyte concentrations. Use blankets to re-warm patients who are mild to moderately hypothermic. Research Watch Box:Sleep, Fatigue & SafetyBy David Page, MS, NREMT-P We are adding to their theoretical knowledge by introducing them to physical objects, dynamic moving vital sign signals, and a moving, breathing simulated patient to make the case come alive. Stage 2: Emergency management of DKA and consideration of abnormal CTG. You might also be interested in our awesome bank of 700+ OSCE Stations. You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ Several environments may be suitable for your classroom. Evenly balancing performance measures will ensure the student has the opportunity to critically think through patient treatment and to practice new or support previously learned behaviors and technical skills. 1. You should have another member of the clinical team aiding you in your ABCDE assessment, such a nurse, who can perform observations, take samples to the lab and catheterise if appropriate. Use an effectiveSBARR handoverto communicate the key information effectively to other medical staff. Cureus 9(5): e1286. 1. This guide has been created to assist students in preparing for emergencysimulationsessionsas part of their training,it is not intended to be relied upon for patient care. This allows the learner group to make a psychological break from the patient and environment while beginning the reflection process. From the Department of Anesthesiology, Pennsylvania State University College of Medicine, Hershey, PA. Dr. Murray is on the Speakers Bureau of METI, Sarasota, FL. Stage 3: Ongoing management and monitoring of DKA 1 hour after initiation of treatment. Collectblood testsafter cannulating the patient including: An ECG should be performed to screen for cardiac pathology such as arrhythmias which may be precipitated by electrolyte abnormalities (e.g. Ziv A, Wolpe PR, Small SD, et al. The following scenarios are available for download and are designed to meet your multi-disciplinary nursing needs. 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. The use of a simulated, evolving case scenario was an effective method of exposing nursing students to complex patient care. The facilitator guides the group only when necessary. This is an important period, as this is where the students see the theoretical concept (metabolic acidosis), come to life as for instance large tidal volumes. Scenarios. Check the patency of the patients right nostril and if required (depending on the model of NPA) insert a safety pin through the flange of the NPA. 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 You can plot as many parameters as you want and can choose to display either Historical data or have the graphs update as often as new data comes in and view them in Real-time. The addition of a fluid infusion containing some potassium allows insulin therapy to continue to suppress ketogenesis and normalise plasma pH whilst preventing the development of hypokalaemia. The impetus for creating and implementing the high-fidelity diabetic ketoacidosis (DKA) simulation was based on a needs assessment and reviewing of undergraduate nursing students' examination statistics in a second semester medical-surgical course. In keeping with the case study, as a treatment marker is reached, the instructor should place emphasis on physiological, pharmacological, environmental and psychosocial issues. A patient with Type I diabetes will often have symptoms related to blood sugar imbalances that appear abruptly with polydipsia, polyuria, polyphagia and rapid weight loss. 4 0 obj 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.