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Publication Date: November 2018 (Volume 20, Number 11)
CME: This issue includes 4 AMA PRA Category 1 Credits™; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2 A or 2B CME credits. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval.
You arrive to work at the regional burn center’s ED, and a nurse pulls you into resuscitation bay 1. Paramedics have presented with a thirtysomething man in cardiac arrest. He had been helping his daughter build a curious device called a Jacob’s ladder—a homemade machine that creates an electrical arc. His presenting rhythm was asystole but by the time of his arrival in the ED, he is in ventricular fibrillation. You wonder if his cardiac arrest is related to the device, and what your next best step is...
As you start work, you wonder where your end-of-shift colleague is. The question is answered when the curtain for bay 2 is pulled back and you see her intubating a young man. She tells you he arrived by ambulance for “burn care.” He fell 12 feet to the ground after his mop pole touched a power line above the semi-trailer he was cleaning. There are minor burns to his hands and chest wall, but more worrisome is the pink fluid draining from his ears and nose. As you assess the patient, you wonder how best to prioritize the patient's workup...