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Open Access Publications from the University of California

Scholarly Works (3 results)

  • Article
  • Peer Reviewed
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 18, Issue 1 (2017)

Metallic corneal foreign bodies (MCFBs) are one of the most common causes of ocular injury presenting to the emergency department. Delays in removal, or forceful attempts to remove the MCFB can lead to infection, further injury to the eye, and worsening of vision. In order to prevent these underlying complications, it is imperative for the medical provider to properly master this technique. As current trends in simulation become more focused on patient safety, task-trainers can provide an invaluable learning experience for residents, medical students and physicians. Models made from bovine eyes, agar plates, gelatin, and corneas created from glass and paraffin wax have been previously been created. One study also used a rubber glove filled with water to simulate intraocular measurement with a Tonopen. However the use of corneas created from ballistics gel for MCFB removal and intraocular pressure measurement has not been studied. We propose a realistic, sustainable, cost-effective MCFB task-trainer to introduce the fundamental skills required for MCFB removal and measurement of intraocular pressure with a Tonopen.  A pilot survey study performed on medical students and emergency medicine resident physicians showed an increase in comfort levels performing both MCFB removal and measurement of intraocular pressure with a Tonopen after using this task-trainer.

    Cover page: Creation of a realistic model for removal of a metallic corneal foreign body for less than $75.Creative Commons 'BY' version 4.0 license
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2017)

    Objective

    The objective was to evaluate the comparative effectiveness of telesimulation versus standard simulation in teaching medical students the management of critically ill patients.

    Methods

    Prospective, randomized crossover study of 32 fourth-year medical students at a university medical simulation center. Students were randomized to the standard simulation (SIM) or telesimulation (TeleSIM) group between September 2014 and February 2015. The SIM group experience included participating in a live, fully immersive simulation case followed by debriefing with their SIM cohort and a live TV Internet connection to the TeleSIM group. The TeleSIM group experience included remotely observing the live simulation case at an off-site location, followed by a shared group debriefing via live TV Internet connection. Subject assessment was performed with a written evaluation tool. During a second instructional session, the students crossed over and participated in a different simulation scenario and assessment. Mean evaluation scores were calculated along with 95% confidence intervals (CIs) and were analyzed via linear regression. Our secondary outcome was a survey evaluating the perceptions and attitudes held between the two simulation modalities.

    Results

    Of 33 eligible students, 32 participated in the study (97.0%). We found no significant difference in the mean evaluation scores of the two groups: SIM group mean = 96.6% (95% CI = 94.5%-98.6%) and TeleSIM group mean = 96.8% (95% CI = 94.8%-98.9%). We also found no significant difference in the favorability of teaching modality (TeleSIM vs. SIM) on the survey.

    Conclusion

    In our prospective randomized crossover study evaluating telesimulation versus standard simulation, we found no significant difference in evaluation scores among the two groups. There was also no significant difference found in the favorability of one teaching modality on a posteducational session survey. Our data support and highlight the capability of telesimulation to provide educational benefit to learners who do not have direct access to simulation resources.
      Cover page: Prospective Randomized Crossover Study of Telesimulation Versus Standard Simulation for Teaching Medical Students the Management of Critically Ill Patients
      • Article
      • Peer Reviewed
      Clinical Practice and Cases in Emergency Medicine, Volume 4, Issue 4 (2020)

      Introduction: Silicone has been commonly used for both major and minor plastic and reconstructive surgery for decades. Due to the high costs associated with minor cosmetic procedures and plastic surgery, the unauthorized use of silicone injections by laypersons has become increasingly common. Improper or illegal subcutaneous injectable silicone has caused significant pulmonary complications and neurological complications, which can range from mild chest pain, hypoxia, and respiratory failure to coma and altered mental status.

      Case Report: We present a patient who had a rare complication of respiratory failure secondary to silicone embolism syndrome (SES). SES is a rare, potentially deadly complication and has been associated with subcutaneous silicone injections. The diagnosis of SES can be challenging and requires a thorough patient history indicating recent cosmetic procedures.

      Conclusion: This case describes the first case of SES of a male patient who presented to a community emergency department complaining of dyspnea after an episode of self-administered injectable silicone into his penis and scrotum and who developed SES-induced respiratory failure.

        Cover page: “Botched”: A Case Report of Silicone Embolism Syndrome After Penile and Scrotal InjectionCreative Commons 'BY' version 4.0 license
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