Impacts of United States Medical Licensing Examination Step 1 Scoring Change on Emergency Medicine Applicant Screening.

Background: The U.S. Medical Licensing Examination (USMLE) Step 1 has been used as a screening tool for residency selection.

The Knowledge Gap: Mentorship in Emergency Medicine Residency.

Study Objective: Studies of mentorship in emergency medicine show that mentored residents are twice as likely to describe their career preparation as excellent as compared to nonmentored peers. There has been significant interest in the mentor-mentee relationship in medicine; however, there is minimal guidance and published literature specific to emergency medicine residents.

Methods: In this narrative review, we described the emergency medicine mentor-mentee relationship, discussed alternatives to the traditional dyadic model, and highlighted current barriers to effective mentorship.

Ketamine is not associated with more post-intubation hypotension than etomidate in patients undergoing endotracheal intubation.

Introduction: Emergency department (ED) patients undergoing emergent tracheal intubation often have multiple physiologic derangements putting them at risk for post-intubation hypotension. Prior work has shown that post-intubation hypotension is independently associated with increased morbidity and mortality. The choice of induction agent may be associated with post-intubation hypotension.

Diagnosing Achilles Tendon Rupture with Ultrasound in Patients Treated Surgically: A Systematic Review and Meta-Analysis.

Background: Achilles tendon rupture is a common injury with increasing incidence due to the rising popularity of high-velocity sports, continued physical activity of the aging American population, and use of fluoroquinolones and steroid injections. The diagnosis can often be missed or delayed, with up to 20% misdiagnosed, most commonly as an ankle sprain.

Objective: The aim of our study was to systematically evaluate the reported sensitivity, specificity, and likelihood ratios of ultrasound for detecting Achilles tendon rupture in patients who were treated surgically.

Large Cerebellar Stroke in a Young COVID-19-Positive Patient: Case Report.

Background: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most frequently presents with respiratory symptoms, such as fever, dyspnea, shortness of breath, cough, or myalgias. There is now a growing body of evidence that demonstrates that severe SARS-CoV-2 infections can develop clinically significant coagulopathy, inflammation, and cardiomyopathy, which have been implicated in COVID-19-associated cerebrovascular accidents (CVAs).

Case Report: We report an uncommon presentation of a 32-year-old man who sustained a large vessel cerebellar stroke associated with a severe COVID-19 infection.

A BERIBERI UNHEALTHY LATTE: ENCEPHALOPATHY AND SHOCK FROM SEVERE NUTRITIONAL DEFICIENCY.

Background: Thiamine deficiency is an uncommon cause of severe illness in the United States that can lead to significant morbidity because of high-output cardiac failure, peripheral neuropathy, and permanent neurologic impairment. We report the case of a middle-aged woman with extreme malnutrition caused by complications of Roux-en-Y gastric bypass (RYGB) surgery who presented with signs and symptoms of severe thiamine deficiency and septic shock.

Case Report: A 43-year-old woman who had undergone RYGB surgery and who had multiple complications presented to the emergency department with agitation, confusion, and lethargy.

Teaching Rapid Assessment Skills in Triage for the Emergency Medicine Clerkship.

Background: Rapidly assessing an undifferentiated patient and developing a gestalt for "sick vs. not sick" is a core component of emergency medicine (EM). Developing this skill requires clinical experience and pattern recognition, which can be difficult to attain during a typical EM clerkship.

Predicting Progression to Septic Shock in the Emergency Department Using an Externally Generalizable Machine-Learning Algorithm.

Study Objective: Machine-learning algorithms allow improved prediction of sepsis syndromes in the emergency department (ED), using data from electronic medical records. Transfer learning, a new subfield of machine learning, allows generalizability of an algorithm across clinical sites. We aim to validate the Artificial Intelligence Sepsis Expert for the prediction of delayed septic shock in a cohort of patients treated in the ED and demonstrate the feasibility of transfer learning to improve external validity at a second site.

Predicting progression to septic shock in the emergency department using an externally generalizable machine learning algorithm.

Objective: Machine-learning (ML) algorithms allow for improved prediction of sepsis syndromes in the ED using data from electronic medical records. Transfer learning, a new subfield of ML, allows for generalizability of an algorithm across clinical sites. We aimed to validate the Artificial Intelligence Sepsis Expert (AISE) for the prediction of delayed septic shock in a cohort of patients treated in the ED and demonstrate the feasibility of transfer learning to improve external validity at a second site.

Multisystem Inflammatory Syndrome in Children (MIS-C) in an Adolescent that Developed Coronary Aneurysms: A Case Report and Review of the Literature.

Background: A small subset of pediatric patients develop a rare syndrome associated with Coronavirus Disease 2019 (COVID-19) infection called multisystem inflammatory syndrome in children (MIS-C). This syndrome shares characteristics with Kawasaki disease.

Case Report: A 15-year-old girl presented to our Emergency Department (ED) with fevers and malaise.

Research and Scholarly Projects.

The idea of doing a research or scholarly project can be very daunting, however, the satisfaction of seeing a project to its completion is very rewarding. In this article, we provide medical students with guidance on whether they should take on a research or scholarly project during medical school, and how to get started, publish, and then present their project. We also highlight how such a project can benefit an applicant applying for residency training.

Development of an International Elective in an Emergency Medicine Residency.

Background: There is a continued interest in global emergency medicine (EM) training, research, and clinical program development. There are many opportunities for "voluntourism" in medicine, but many of these experiences do not have standard goals and objectives.

Objective: This article describes a rotation for EM residents from the United States to have a structured learning experience focusing on emergency medical settings in the prehospital phase (something often lacking in U.

Accuracy of a SET of Screening Parameters Developed for the Diagnosis of Arterial Gas Embolism: The SANDHOG Criteria.

Background: Arterial gas embolism (AGE) is a major cause of morbidity and mortality in self-contained underwater breathing apparatus (SCUBA) diving and certain medical procedures. There are currently no well-defined criteria to diagnose AGE. Emergency physicians often find themselves facing a decision whether or not a patient with dive-related symptoms has an AGE and needs to be transferred to a hyperbaric facility.

Mass sociogenic illness initially reported as carbon monoxide poisoning.

Background: Mass sociogenic illness (MSI) is a rare occurrence involving a constellation of physical signs and symptoms in a group of individuals that are exhibited subconsciously and have no corresponding organic etiology.

Objectives: To describe an outbreak of MSI initially attributed to carbon monoxide (CO) poisoning.

Case Reports: While attending a church service, one child fainted, followed by another.