SimWars
This post is part of a series developed in preparation for participation in ACEP SimWars. It contains a review of several prominent emergency medicine topics which may be relevant for board preparation. Unless otherwise cited, content is based on HippoEM videos.
- Pediatric Emergencies
- Altitude and Dysbarism
- Bites
- Electrical Injuries
- Heat Emergencies
- Hypothermia
- Radiation Exposure
- Submersion Injury
- Hematologic Emergencies
- Bleeding Disorders
- Oncologic Emergencies
- Adrenal/Pituitary Emergencies
- Thyroid Emergencies
- Acid-Base Disturbances
- Dermatologic Emergencies
- Toxicology
Pathophysiology
- Breath-holding until eventual involuntary gasp which triggers reflexive laryngospasm. Resultant loss of consciousness may cause laryngeal relaxation and aspiration.
- Fluid aspiration results in decreased surfactant activity and atelectasis. This is complicated by V/Q mismatch and atelectrauma which can lead to ARDS.
Symptoms
- Progressive respiratory distress
- AMS: due to cerebral hypoxia
- Shock: uncommon, consider trauma
Management
- Albuterol
- BiPAP
- Endotracheal intubation
- ECMO
Disposition
- Asymptomatic or minor event: observe 2-3 hours
- Mildly symptomatic: observe 4-6 hours
- Hypoxia: admit
- PPV: ICU