Case Report: Here we present a case of bilateral extensor tenosynovitis in a 52-year-old female denying past medical history who presented to the ED with two days of bilateral dorsal hand swelling and pain. She denied any risk factors such as direct trauma to the hands or intravenous drug use. The rare diagnosis was suspected in the ED due to a very high complement reactive protein level and a concerning point-of-care ultrasound. Extensor tenosynovitis was ultimately confirmed on computed tomography and by operative irrigation and drainage of the tendon sheaths. 

Conclusion: This case demonstrates the importance of keeping extensor tenosynovitis on the differential when seeing a patient with dorsal extremity edema and pain, even if the findings occur bilaterally. 

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Introduction: Effective leadership improves patient care during medical and trauma resuscitations. While dedicated training programs can improve leadership in trauma resuscitation, we have a limited understanding of the optimal training methods. Our objective was to explore learners’ and teachers’ perceptions of effective methods of leadership training for trauma resuscitation.

Methods: We performed a qualitative exploration of learner and teacher perceptions of leadership training methods using a modified grounded theory approach. We interviewed 28 participants, including attending physicians, residents, fellows, and nurses who regularly participated in trauma team activations. We then analyzed transcripts in an iterative manner to form codes, identify themes, and explore relationships between themes.

Results: Based on interviewees’ perceptions, we identified seven methods used to train leadership in trauma resuscitation: reflection; feedback; hands-on learning; role modeling; simulation; group reflection; and didactic. We also identified three major themes in perceived best practices in training leaders in trauma resuscitation: formal vs informal curriculum; training techniques for novice vs more senior learner; and interprofessional training. Participants felt that informal training methods were the most important part of training, and that a significant part of a training program for leaders in trauma resuscitation should use informal methods. Learners who were earlier in their training preferred more supervision and guidance, while learners who were more advanced in their training preferred a greater degree of autonomy. Finally, participants believed leadership training for trauma resuscitation should be multidisciplinary and interprofessional.

Conclusion: We identified several important themes for training leaders in trauma resuscitation, including using a variety of different training methods, adapting the methods used based on the learner’s level of training, and incorporating opportunities for multidisciplinary and interprofessional training. More research is needed to determine the optimal balance of informal and formal training, how to standardize and increase consistency in informal training, and the optimal way to incorporate multidisciplinary and interprofessional learning into a leadership in trauma resuscitation training program.