for common procedures. The aim of the study was to provide new trainees with an opportunity for repetitive practice and skill acquisition. Methods/Results: This is a single-centered prospective study from Jan 2020-Oct 2022. Subjects were first year internal medicine residents, prior to their Intensive Care Unit (ICU) rotation. Subjects received a survey 1 week prior to their simulation training to assess their confidence in procedures and their perceived competency level. Subjects also received a link to educational videos of how to place a central venous catheter, arterial line, and how to perform a paracentesis, thoracentesis, and lumbar puncture. They were then provided with an opportunity to practice each procedure 3-5 times during their simulation training on mannequins. Subjects were asked how confident and competent they feel after their training in a follow up survey. A total of 41 residents completed the simulation training session. Based on survey results prior to
simulation training, 22% of respondents (n=9) thought it is “extremely likely” that the training session will improve their confidence in procedural skills. This percentage increased to 51% (n=21) post training (p = 0.004). In terms of competence, 24% (n = 10) of the subjects responded with “extremely likely” when asked whether the training simulation will increase their competence in procedures, which increased to 53.6% (n = 22) post training (p = 0.01). Discussion: We designed a 3-hour simulation-based training on basic ICU procedures that significantly improved our trainee’s confidence and competence in performing procedures in high acuity settings. We demonstrate the importance of skill acquisition through repetition by providing educational material prior to simulation training to allow trainees to familiarize themselves with procedural protocols prior to the development of procedural skills. Simulation-based training can significantly improve trainee’s competency and maximize patient safety.
SJÖGREN’S AND VALVULAR ENDOCARDITIS: CARIES AND CARDIOVASCULAR RISK Thomas Jason Simon; Department of Medicine, LSU Health Sciences Center, Lafayette, LA.
Introduction: Sjögren’s syndrome is an autoimmune process characterized by oral and ocular dryness, with 30-40% of patients demonstrating systemic manifestations commonly involving the lungs, kidneys, and bile ducts. Cardiac complications
aortic valve without valvular dysfunction. Subsequent TEE confirmed the location and size of the density along with a tricuspid AV anatomy. Rheumatology was consulted and steroids were recommended. Labs revealed a positive SSA-52, SSA-60, SSB, and RF. Final speciation showed Staphylococcus epidermidis and was deemed a contaminant. Six weeks of outpatient antibiotic therapy was completed to treat the culture-negative endocarditis. Her symptoms improved with recommendations to follow up with Rheumatology and Cardiology. Repeat echocardiogram showed resolution of the mass and thickening of the aortic valve. Discussion: There have only been a handful of reported cases of concomitant Sjögren’s and endocarditis. Autoimmune diseases can present a variety of unexpected outcomes as result of a heterogenous pathophysiology. Glandular dysfunction in Sjögren’s can run a stable and chronic course with prolonged dryness and poor oral health. An increased endocarditis risk may be just one contributor to a possible burden of heart disease in Sjögren’s syndrome.
in Sjögren’s are less established and may be an underrecognized phenomenon.
Case: A 59-year-old female with Sjögren’s syndrome and Interstitial Lung Disease presented with shortness of breath, cough, weight loss, and fever. Fifteen years prior, she was found to have lung scarring after a spontaneous pneumothorax and a presumptive diagnosis of Sjögren’s was made after she developed sicca syndrome. At that time patient declined disease modifying treatment. She reported recurrent fevers following a full dental extraction two months prior to presentation. She was currently found to be febrile, hypotensive, hypoxic, and tachycardic. She had an elevated white count and CT of the lungs showed chronic widespread parenchymal changes with bibasilar interstitial fibrosis and a superimposed infectious process. Patient was treated empirically for pneumonia, while one of two blood cultures grew gram-positive cocci. TTE showed a 4x5mm non-mobile density on the non-coronary cusp of the
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