Matthew Fell, Ginette Phippen, Stephanie van Eeden, David Chong, Marc C Swan, Simon van Eeden, John B Carlin
Analysis and Reporting of Randomized Trials in Cleft Palate Surgery: Learning from the Timing of Primary Surgery (TOPS) Trial
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
simulation appropriate emergency medicine em residents levels peripartum cardiomyopathy ppcm rare idiopathic condition occurs mother around time childbirth heart failure reduced ejection fraction andor reduced systolic function diagnosed patients last month pregnancy five months following delivery defines pccm1 another broader definition european society cardiology defines ppcm heart failure occurs towards end pregnancy months following delivery cause heart failure found2 though ppcm occurs worldwide data extracted united states incidence 1900 14000 live births nigeria haiti south africa34risk factors ppcm include preeclampsia multiparity advanced maternal age unfortunately complete pathophysiology ppcm remains unclear however important emergency physicians aware rare diagnosis though 5080 women ppcm may eventually recover normal left ventricle systolic function5 positive outcomes depend timely recognition ppcm disease appropriate management heart failure symptomatic ppcm emergent condition requires attentive knowledgeable emergency medicine physician rapid recognition treatment simulation rare condition give residents experience identifying managing disease might otherwise see personally training end simulation session learners able 1 initiate workup pregnant patient presents syncope 2 accurately diagnose peripartum cardiomyopathy 3 demonstrate care gravid patient respiratory distress due peripartum cardiomyopathy 4 appropriately manage cardiogenic shock due peripartum cardiomyopathy simulation conducted highfidelity medical simulation case followed debriefing could potentially adapted use lowfidelity case oral boards exam case educational content clinical applicability simulation evaluated oral written feedback participant groups large threeyear emergency medicine residency training program participant completed case facilitated debriefing afterwards case facilitators also provided personal observations implementation simulation participants gave simulation positive feedback n18 seventeen em residents one pediatric emergency medicine pem fellow participated feedback survey learners overall agreed 1875 strongly agreed 8125 participating simulation would improve performance live clinical setting peripartum cardiomyopathy low frequency high acuity illness requires synthesis learners knowledge complex physiology navigation logistical systemsbased challenges advanced communication leadership skills ensure best possible patient outcome em physicians expected expertly manage illness completion em training program yet every em resident encounter type patient training supplementing em residents standard training simulation experience provides psychologically educationally safe space learn possibly make mistakes without causing patient harm practically residents able correctly diagnose patient cardiomyopathy even familiar diagnosis peripartum cardiomyopathy residents particularly enjoyed case explore concepts benefits risks medical therapeutics ie positive pressure ventilation vasopressorsinotropes safe practice gravid patient case associated high yield debriefing session effective teaching tools emergency medicine residents ppcm medical simulation peripartum cardiomyopathy pregnancy respiratory failure cardiogenic shock emergent cesarian section