Tracheoinnominate Artery Fistula.

Audience: This simulation provides training for emergency medicine residents in the stepwise management of a patient who presents with bleeding from a tracheoinnominate artery fistula. Additional learners who might benefit from this simulation are otolaryngology and general surgery residents as well as critical care fellows.

Introduction: Hemorrhage from a tracheoinnominate artery fistula (TIAF) is a rare but life-threatening complication in a patient with a recent tracheostomy.

Preventing and Treating Hypoxia: Using a Physiology Simulator to Demonstrate the Value of Pre-Oxygenation and the Futility of Hyperventilation.

Introduction: Insufficient pre-oxygenation before emergency intubation, and hyperventilation after intubation are mistakes that are frequently observed in and outside the operating room, in clinical practice and in simulation exercises. Physiological parameters, as appearing on standard patient monitors, do not alert to the deleterious effects of low oxygen saturation on coronary perfusion, or that of low carbon dioxide concentrations on cerebral perfusion. We suggest the use of HumMod, a computer-based human physiology simulator, to demonstrate beneficial physiological responses to pre-oxygenation and the futility of excessive minute ventilation after intubation.

The use of simulation in healthcare: from systems issues, to team building, to task training, to education and high stakes examinations.

Purpose Of Review: Simulation in healthcare is becoming increasingly used. This review will spotlight some of the uses of simulation in healthcare training.

Recent Findings: Previously, evaluation of simulation training was typically from evaluations from trainees.

Inadvertent poisoning of seven teenagers with monosodium methanearsonate.

Introduction: Monosodium methanearsonate (MSMA) is an organo-arsenic containing herbicide. There is scant information available concerning the toxicity of this chemical in humans.

Case Report: Seven male teenagers, 15-18 years of age, inadvertently used a MSMA herbicide as cooking oil to fry fish.

Chemical colitis from a hydrogen peroxide enema.

Background: Constipation is a common complaint seen in the emergency department for which patients will try many different remedies.

Objectives: This case report discusses the outcome of a patient who developed a chemical colitis after using a hydrogen peroxide enema to relieve his constipation.

Case Report: A 43-year-old male with a history of chronic constipation presented to the Emergency Department (ED) with complaints of abdominal pain and hematochezia after self-administering a commercial sodium phosphate/sodium biphosphate enema mixed with hydrogen peroxide.