Emergency Medicine Simulation Workbook

3 Chapter 3FIGURE 3.1 Pediatric chest x‐ray (normal).FIGURE 3.2 Pediatric abdominal x‐ray (normal).FIGURE 3.3 Abdominal ultrasound showing small‐bowel wall thickening.FIGURE 3.4 Case flow diagram, Henoch–Schönlein purpura.FIGURE 3.5 Femur x‐ray showing subcutaneous air without fracture.FIGURE 3.6 Soft‐tissue ultrasound showing emphysema along the deep fascia, a...FIGURE 3.7 Computed tomography of the thigh showing the presence of gas in t...FIGURE 3.8 Case flow diagram for necrotizing fasciitis.FIGURE 3.9 Chest x‐ray showing right lower lobe infiltrate.FIGURE 3.10 Case flow diagram for toxic epidermal necrolysis.

4 Chapter 4FIGURE 4.1 Electrocardiogram with sinus tachycardia.FIGURE 4.2 Flow diagram for heat injury.FIGURE 4.3 Flow diagram for jellyfish envenomation.FIGURE 4.4 Flow diagram for high‐altitude pulmonary edema.

5 Chapter 5FIGURE 5.1 Pediatric computed tomography head slice showing intracerebral he...FIGURE 5.2 Factor replacement.FIGURE 5.3 Flow diagram of intracranial hemorrhage in patient with hemophili...FIGURE 5.4 Electrocardiogram showing sinus tachycardia.FIGURE 5.5 Chest x‐ray (normal).FIGURE 5.6 Computed tomography head slice (normal).FIGURE 5.7 Flow diagram of thrombotic thrombocytopenic purpura.FIGURE 5.8 Electrocardiogram showing peaked T waves.FIGURE 5.9 Chest x‐ray (normal).FIGURE 5.10 Flow diagram of tumor lysis syndrome.

6 Chapter 6FIGURE 6.1 X‐ray chest post‐intubation.FIGURE 6.2 Angioedema lip swelling.FIGURE 6.3 Flow diagram for angioedema.FIGURE 6.4 Flow diagram for pediatric anaphylaxis.FIGURE 6.5 X‐ray anteroposterior knee.FIGURE 6.6 X‐ray lateral knee.FIGURE 6.7 Flow diagram for reactive arthritis.

7 Chapter 7FIGURE 7.1 Chest x‐ray with scattered opacities.FIGURE 7.2 Abdominal x‐ray (normal).FIGURE 7.3 Post‐intubation chest x‐ray demonstrating appropriate endotrachea...FIGURE 7.4 Electrocardiogram with sinus tachycardia and short PR interval.FIGURE 7.5 Flow diagram for sepsis.FIGURE 7.6 Chest x‐ray preintubation, demonstrating bilateral streaking.FIGURE 7.7 Post‐intubation chest x‐ray.FIGURE 7.8 Computed tomography of the head without contrast.FIGURE 7.9 Flow diagram for meningitis.FIGURE 7.10 Chest x‐ray (normal).FIGURE 7.11 Flow diagram for Ebola.

8 Chapter 8FIGURE 8.1 Right tibia/fibula x‐ray (normal).FIGURE 8.2 Right knee x‐ray (normal).FIGURE 8.3 Chest x‐ray (normal).FIGURE 8.4 Computed tomography of the head ( representative slice, normal).FIGURE 8.5 Flow diagram for rhabdomyolysis.FIGURE 8.6 Right hip x‐ray showing slipped capital femoral epiphysis.FIGURE 8.7 Right knee x‐ray (normal).FIGURE 8.8 Flow diagram for slipped capital femoral epiphysis.FIGURE 8.9 Lumbar x‐ray (normal).FIGURE 8.10 Magnetic resonance imaging report, which states cauda equina com...FIGURE 8.11 Flow diagram for cauda equina.

9 Chapter 9FIGURE 9.1 Neonatal heart monitor strip (heart rate 86).FIGURE 9.2 Neonatal heart monitor strip (heart rate 48).FIGURE 9.3 Breech flow diagram.FIGURE 9.4 Crowning fetal head.FIGURE 9.5 Head delivered.FIGURE 9.6 Shoulder dystocia flow diagram.FIGURE 9.7 Complete placenta.FIGURE 9.8 Ultrasound of uterus with no retained products.FIGURE 9.9 Postpartum hemorrhage flow diagram.

10 Chapter 10FIGURE 10.1 Electrocardiogram showing normal sinus rhythm.FIGURE 10.2 Chest x‐ray (normal).FIGURE 10.3 Computed tomography of the head, showing dense left middle cereb...FIGURE 10.4 Computed tomography angiography showing no large vessel occlusio...FIGURE 10.5 Computed tomography angiography showing left M1 occlusion.FIGURE 10.6 National Institutes of Health Stroke Scale.FIGURE 10.7 Patient's National Institutes of Health Stroke Scale.FIGURE 10.8 Flow diagram for AIS (min, minutes; RA, room air).FIGURE 10.9 Electrocardiogram showing atrial fibrillation.FIGURE 10.10 Chest x‐ray (normal).FIGURE 10.11 Computed tomography of the head showing right basal ganglia int...FIGURE 10.12 Flow diagram for intracerebral hemorrhage (FFP, fresh frozen pl...FIGURE 10.13 Chest x‐ray (normal).FIGURE 10.14 Computed tomography of the head (normal).FIGURE 10.15 Electrocardiogram showing sinus tachycardia.FIGURE 10.16 Flow diagram for status epilepticus in a child (FiO 2, fraction ...

11 Chapter 11FIGURE 11.1 Flow diagram for sexual assault.FIGURE 11.2 Chest x‐ray radiology read.FIGURE 11.3 Right femur x‐ray radiology read.FIGURE 11.4 Computed tomography of the head radiology read.FIGURE 11.5 Flow diagram for non‐accidental trauma with aggressive family me...FIGURE 11.6 Chest x‐ray (normal).FIGURE 11.7 Computed tomography of the head (normal).FIGURE 11.8 Triage sheet at presentation for delirium tremens.FIGURE 11.9 Flow diagram for delirium tremens.

12 Chapter 12FIGURE 12.1 Electrocardiogram demonstrating peaked T waves of hyperkalemia....FIGURE 12.2 Chest x‐ray demonstrating mild pulmonary edema.FIGURE 12.3 Normalized electrocardiogram demonstrating resolution of peaked ...FIGURE 12.4 Scenario flow diagram for acute kidney injury.FIGURE 12.5 Chest x‐ray (normal).FIGURE 12.6 Electrocardiogram demonstrating sinus tachycardia.FIGURE 12.7 Computed tomography of the abdomen/pelvis demonstrating scrotal ...FIGURE 12.8 Scenario flow diagram for Fournier's gangrene.FIGURE 12.9 Scenario flow diagram for pediatric priapism.

13 Chapter 13FIGURE 13.1 Electrocardiogram showing sinus tachycardia.FIGURE 13.2 Chest x‐ray, no acute findings.FIGURE 13.3 Post‐intubation chest x‐ray showing appropriate endotracheal tub...FIGURE 13.4 Flow diagram for chronic obstructive pulmonary disease.FIGURE 13.5 Chest x‐ray, diffuse pulmonary edema.FIGURE 13.6 Post‐intubation chest x‐ray showing appropriate endotracheal tub...FIGURE 13.7 Flow diagram for acute respiratory distress syndrome.FIGURE 13.8 Lateral neck x‐ray showing enlarged epiglottis (thumbprint sign)...FIGURE 13.9 Chest x‐ray, no acute findings.FIGURE 13.10 Post‐intubation chest x‐ray showing appropriate endotracheal tu...FIGURE 13.11 Flow diagram for epiglottitis.

14 Chapter 14FIGURE 14.1 Electrocardiogram showing sinus tachycardia.FIGURE 14.2 Chest x‐ray showing no acute abnormality.FIGURE 14.3 Computed tomography of the head showing no acute intracranial ab...FIGURE 14.4 Scenario flow diagram for aspirin overdose.FIGURE 14.5 Electrocardiogram showing first‐degree atrioventricular block an...FIGURE 14.6 Chest x‐ray showing no acute abnormality.FIGURE 14.7 Post‐intubation chest x‐ray showing appropriate endotracheal tub...FIGURE 14.8 Computed tomography of the head showing no acute intracranial ab...FIGURE 14.9 Flow diagram for lithium toxicity.FIGURE 14.10 Ethylene glycol toxicity case: electrocardiogram showing sinus ...FIGURE 14.11 Chest x‐ray showing no acute abnormality.FIGURE 14.12 Post‐intubation chest x‐ray showing appropriate endotracheal tu...FIGURE 14.13 Computed tomography of the head interpretation showing no acute...FIGURE 14.14 Flow diagram for ethylene glycol toxicity.

15 Chapter 15FIGURE 15.1 Right upper quadrant ultrasound showing intraperitoneal free flu... FIGURE 15.2 Left upper quadrant ultrasound showing intraperitoneal free flui...FIGURE 15.3 Suprapubic ultrasound showing intraperitoneal free fluid.FIGURE 15.4 Subcostal ultrasound still image showing no pericardial free flu...FIGURE 15.5 Chest x‐ray showing no acute abnormality.FIGURE 15.6 Post‐intubation chest x‐ray showing appropriate endotracheal tub...FIGURE 15.7 X‐ray of the pelvis showing no acute abnormality.FIGURE 15.8 X‐ray of the left femur showing a comminuted mid‐shaft femur fra...FIGURE 15.9 Head computed tomography showing no acute intracranial abnormali...FIGURE 15.10 Abdominal computed tomography showing a grade‐4 splenic lacerat...FIGURE 15.11 Flow diagram for hemorrhagic shock.FIGURE 15.12 Post‐intubation chest x‐ray showing appropriate endotracheal tu...FIGURE 15.13 Head computed tomography showing a subdural hematoma.FIGURE 15.14 Flow diagram for non‐accidental trauma.FIGURE 15.15 Chest x‐ray showing right pneumothorax.FIGURE 15.16 Chest x‐ray showing right pneumothorax with thoracostomy tube i...FIGURE 15.17 Chest x‐ray showing right pneumothorax with thoracostomy tube i...FIGURE 15.18 Chest x‐ray showing right pneumothorax with appropriate endotra...FIGURE 15.19 Right thoracic ultrasound showing normal lung sliding.FIGURE 15.20 Left thoracic ultrasound showing normal lung sliding.FIGURE 15.21 Right upper quadrant ultrasound showing intraperitoneal free fl...FIGURE 15.22 Left upper quadrant ultrasound showing intraperitoneal free flu...FIGURE 15.23 Suprapubic ultrasound showing intraperitoneal free fluid.FIGURE 15.24 Subcostal ultrasound showing no pericardial free fluid.FIGURE 15.25 Flow diagram for penetrating chest trauma.