A Novel, Reusable, Ultrasound-Guided Pericardiocentesis Simulation Model.

Given the rarity of emergency pericardiocentesis, deliberate effort must be made by the physician to maintain competence in performing this procedure. Herein we describe the construction of a low-cost, reusable, high-fidelity simulation model for ultrasound-guided pericardiocentesis. Sixteen emergency medicine residents participated in a procedure lab using the model and then evaluated the model's efficacy using a survey.

Medial Pontomedullary Stroke Mimicking Severe Bell's Palsy: A Case Report.

Introduction: Patients with acute unilateral upper and lower facial palsy frequently present to the emergency department fearing they have had a stroke, but many cases are benign Bell's palsy.

Case Report: We present a rare case of a medial pontomedullary junction stroke causing upper and lower hemifacial paralysis associated with severe dysphagia and contralateral face and arm numbness.

Conclusion: Although rare, pontine infarct must be considered in patients who present with both upper and lower facial weakness.

Development and Evaluation of an Objective Tympanic Membrane Visualization Assessment Technique.

Objectives: To introduce an inexpensive method for objectively evaluating otoscopic visualization of the tympanic membrane wherein learners match what they visualize in standardized patients to tympanic membrane photographs.

Methods: Two standardized patients had photographs taken of their tympanic membranes using a commercially-available digital otoscope. First- and third-year medical students were asked to perform an otoscopic examination on each patient using a conventional handheld otoscope and to match what they saw with the correct tympanic membrane image among distractor photographs belonging to other patients.

Utility of a smartphone-enabled otoscope in the instruction of otoscopy and middle ear anatomy.

Purpose: To present the utility of a smartphone-enabled otoscope as a teaching adjunct in pre-clinical otoscopy training.

Methods: 60 pre-clinical medical students were randomized into either a control group using a conventional otoscope or an experimental group using a smartphone-enabled otoscope. Participants in each group were trained to use their assigned device and were given time to practice on a colleague's ear.

A perioperative care map improves outcomes in patients with morbid obesity undergoing major surgery.

Background: The surgical management of patients with morbid obesity (body mass index ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items.