Acute superior vena cava syndrome after rupture of Kommerell's diverticulum: a case report.

Kommerell's diverticulum, a rare congenital aortic anomaly, is dilatation at the region in which an aberrant subclavian artery branches from either a left-sided or right-sided thoracic aorta. We report a rare case of acute superior vena cava syndrome that developed in a young healthy male patient who presented to the emergency department in imminent respiratory arrest after rupture of this diverticulum.

Simulation Training for In-Flight Medical Emergencies Improves Provider Knowledge and Confidence.

INTRODUCTION: In-flight medical emergencies require healthcare providers to operate in confined spaces with limited resources and delayed access to definitive care. These emergencies are common, with an estimated frequency of 1 per 100 to 1000 flights. Despite this, training for medical response in these environments is limited. We hypothesize that integrating such education into a pre-existing medical student elective course would improve knowledge and ability to respond appropriately to in-flight medical emergencies.METHODS: The available literature surrounding in-flight medical emergencies was reviewed. Syncope, respiratory distress, allergic reaction, and cardiac arrest were identified as common and potentially life-threatening complaints. Simulation cases were designed for each of these complaints and a simulation room was modified to mimic an airplane cabin. These simulation cases and accompanying relevant didactic lectures were incorporated into an existing wilderness and extreme environmental medicine course, with multiple-choice tests completed by the students at the beginning and end of the 2-wk course.RESULTS: Participating in this study were 18 students. The pretest average was 76%, which improved to 87% on the posttest. Qualitative feedback regarding this type of training was overwhelmingly positive.DISCUSSION: Simulation-based training for in-flight medical emergencies can significantly improve medical students' knowledge. This training was very well received by the students. Opportunities for training to manage in-flight medical emergencies remain limited; incorporating such training into existing curricula could provide a means by which to improve provider knowledge. Such a curriculum could be adapted for use by flight crews and other populations.Padaki A, Redha W, Clark T, Nichols T, Jacoby L, Slivka R, Ranniger C, Lehnhardt K. Simulation training for in-flight medical emergencies improves provider knowledge and confidence. Aerosp Med Hum Perform. 2018; 89(12):1076-1079.