406TF A RASHonal Approach to the Diagnosis of Dermatologic Emergencies

Abstract

Dermatologic complaints are common presentations to the emergency department. Though most causes of rash are benign, it is critical that emergency physicians be able to recognize the dermatologic manifestations of critical illness. In 1984 Lynch et al proposed an algorithmic approach to the identification of dermatologic processes, and since then several modified Lynch algorithms have been developed and expanded. This learning module will introduce learners to an established series of algorithms designed to organize and narrow the differential diagnosis of serious rash. Learners will be challenged to sort the classic rashes of many dermatologic diseases using this approach and will practice recognizing the classic rashes of many dermatologic emergencies. This module is intended for medical students and both junior and senior learners in emergency medicine and is designed to be presented at didactic conference. By the end of this learning module, the learner will be able to: 1.) apply a systematic approach to the evaluation of acute dermatologic disease; 2.) categorize the classic rashes of many dermatologic emergencies, utilizing a visual diagnosis approach; 3.) develop pattern recognition in the identification of dermatologic emergencies; 4.) discuss the etiology, presentation, examination, complications, diagnosis and treatment of patients with various dermatologic diseases. This module is a modified team-based learning session. Learners will complete a preparatory self-directed module prior to attending didactic conference that will review the approach to an undifferentiated rash, key elements of the history and physical exam, history/physical red flags, and rash morphology. This will be followed by a short Individual Readiness Assurance Test (IRAT). At the beginning of the didactic session, teams of 5-7 learners with participate in a Team Readiness Assurance Test (TRAT). For the application exercise, pictorial examples of many serious dermatologic conditions will be presented, and teams will compete to correctly identify them. Rashes will be classified into one of four categories (petechial/purpuric, erythematous, maculopapular, and vesiculobullous) and sorted into diagnostic algorithms. The exercise will focus on visual examples in order to develop pattern recognition. Learners will be evaluated by an IRAT, a TRAT, and by a short post-module survey to assess the learner’s subjective ability to identify and manage dermatologic emergencies. Recognizing potentially life-threatening dermatologic disease is a critical skill for the emergency physician. This educational module will provide learners with the tools to promptly recognize the most critical rashes, and to ensure that life-threatening conditions are not overlooked.