But Can You Just PO?

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But Can You Just PO?

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causes—some requiring IV fluid resuscitation and others requiring none. Considering the nationwide IV fluid shortage, judicious use of fluids is imperative. Thus, this begs the question, who really needs IV fluids, and can the patient simply hydrate orally? This article serves to briefly discuss IV fluids administration in the ED and the instances where they are not indicated. 

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Grand Rounds Recap 11.13.24

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Grand Rounds Recap 11.13.24

Welcome to another week of Grand Rounds! Join us for Sports Medicine Grand Rounds, where he discuss cases from the training room, followed by a discussion on rabies prophylaxis. Two of our wonderful R2s gave their QI/KT on acetaminophen overdose, then we had a review of landmark studies in Emergency Medicine. We had an R4 discharge/transfer/treat case discussion, and ended the day with a pediatrics lecture!

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Grand Rounds Recap 11.6.24

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Grand Rounds Recap 11.6.24

Another week, another Grand Rounds! Dr. Boggust took us through the basic of management of patients with Multiple Sclerosis in the ED. Then, Dr. Grisoli presented her Capstone on the treatment and care of patients with disabilities. Finally, Dr. Minges and the rest of the ultrasound team discussed MSK ultrasounds, with hands on session for the most frequent upper and lower extremity scans!

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Grand Rounds Recap 10.30.24

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Grand Rounds Recap 10.30.24

Join us for another great week of Grand Rounds! We started out with a great discussion of the changing workforce and how the differences between generations and leadership styles impacts our interactions with our colleagues. Then we discussed the nuances of managing a dysfunctional tracheostomy with Dr. Adan. We were taken through the pathophysiology and clinical presentation of patients with pneumomediastinum and mediastinitis with Dr. Valles. Finally, Drs. Artiga, Beyde and Vaishnav gave us hands on practice with the different types of nerve blocks that can be used in the ED!

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A New Tool to Help Screen for Sepsis in Kids?

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A New Tool to Help Screen for Sepsis in Kids?

Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When utilizing a cut off of ≧ 2 points, the qPS4 was highly sensitive and specific, and identified pediatric septic shock far sooner into a patient's course.

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Grand Rounds Recap 10.23.24

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Grand Rounds Recap 10.23.24

Join us for another exciting week of Grand Rounds! This week, we had Morbidity and Mortality conference with Dr. Gobble. This was followed by CPC with Drs. Qin and Bryant. Next, Dr. Wilson walked us through a case of methoglobinemia caused by sodium nitrite toxicity. We finished up the day with Dr. Wright’s capstone on rural emergency medicine.

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Diagnostics and Therapeutics: Pneumomediastinum

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Diagnostics and Therapeutics: Pneumomediastinum

Pneumomediastinum is defined as the infiltration of air into the mediastinum and its structures. This disease process can be benign, but also requires careful evaluation and management, and in severe cases may require surgical intervention. This post helps the emergency physician learn to both identify and treat this rare but important clinical entity.

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Diagnostics: Thromboembolic Disease in Pregnancy

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Diagnostics: Thromboembolic Disease in Pregnancy

Venous thromboembolisms (VTE) are difficult enough to diagnose and treat in the standard patient. However, this becomes even more of a challenge in the pregnant patient. In this post, we will discuss in depth the work up of VTE in the pregnant patient, which often requires slightly different risk stratification tools. We will also discuss various treatment options for VTE in pregnancy and the post partum period.

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Grand Rounds Recap 9.25.2024

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Grand Rounds Recap 9.25.2024

Join us for another exciting week of Grand Rounds! This week, we had Morbidity and Mortality conference where we learned about posterior hip dislocations, hypertensive emergency, subacute combined degeneration secondary to nitrous oxide use, spinal epidural abscesses, small bowel obstructions, management of agitation in the Emergency Department, and status epilepticus. This was followed up by an R3 Taming the SRU lecture on high-grade heart block and transvenous pacemakers and a discussion on finding your niche in academic emergency medicine. We had an exciting R2 CPC case of acute salicylate toxicity, followed by intern core content with a discussion of penile disorders and urologic emergencies, and ended the day with Dr. Sobocinski's R4 capstone.

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Is Your Head Spinning? The Sudbury Vertigo Risk Score

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Is Your Head Spinning? The Sudbury Vertigo Risk Score

There is a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks. The authors of this study set out to create a risk score to apply to patients who present to the ED with vertigo which would identify the patients at risk for serious pathology (which they defined as stroke, TIA, vertebral artery dissection, or brain tumor).

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