Often the ED is the source of routine care after incarceration, and that is often secondary to issues with medicaid lapsing during incarceration and dropping a key linkage to care. Join Dr. Kate Gallen as she examines why this can happen as the first step to improving the system is knowing where it fails.
Read MoreEsophageal food impaction (EFI) occurs at an estimated rate of 13 episodes per 100,000 people annually. Medical management is typically attempted before resorting to endoscopy to reduce procedural risks and resource use. Glucagon remains the most widely used medication. Other treatments include carbonated beverages, benzodiazepines, and, more recently, nitroglycerin. Despite glucagon being the most commonly used agent, its supporting data are limited to small studies or case reports. One older study showing over 60% efficacy lacked a comparator group and had multiple confounders. Another study suggested only minimal benefit and significant adverse effects—up to 50% vomiting—highlighting the need for better treatment options.
Read MoreDr Boggust walks us through the most important considerations for patients who present to the Emergency Department with inhalation injuries from smoke and other noxious chemicals.
Read MoreTumor lysis syndrome (TLS) is rare disease presentation in the emergency department that is very important to learn to diagnose and treat due to the high associated mortality, often quoted at 20% or more. This post discussed the pathophysiology of the disease process, as well as how to appropriate identify and treat TLS in a timely manner to prevent complications such as cardiac dysrhythmias and acute renal failure.
Read MoreAnother week, another great Grand Rounds! First, Dr. Lang takes us through the evidence behind our common treatment of low back pain. Next, Drs. Boyer and Segev give us a evidence guided management of the acutely ischemic limb. Next, Dr. Hajdu takes us through a difficult case of cardiac arrest in the ED. Finally, we learn all about infections of the pelvis and perineum with Dr. Guay!
Read MoreNot all breathing is made equal, and a lot of it wheezes in the world of Emergency Medicine. Join Dr. Blaine Oldham as he reviews asthma and COPD and how to approach each with some nuance
Read MoreIt can be a challenge to differentiate NMS and Serotonin syndrome, careful attention to historical factors, a thorough medication history, and a detailed physical exam and neurologic exam is necessary to quickly diagnose these patients. This post details the presentation of each entity and highlights the differences between the two.
Read MoreFluid 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.
Read MoreDr. Dixon walks us through an overview of sarcoidosis and the many complications we must look out for in the emergency department.
Read MorePersistent or intractable hiccups can be both a diagnostic and therapeutic conundrum for the emergency physician. Dr. Charlie Reed takes us through the pathophysiology, evaluation and treatment of this condition, and reveals the dangers that can be harbored by this common symptom.
Read MoreWelcome 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!
Read MoreAnother 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!
Read MoreJoin 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!
Read MoreCurrent 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.
Read MoreJoin 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.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
