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!
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 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 Research and Peer Review Basics with Dr. Freiermuth, Pediatric airway cases, hand injuries and how we can better ensure a safe discharge in trauma
Read MoreJoin 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.
Read MoreThere 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).
Read MoreJoin us as one our OBGYN consultants, Dr. Pensak, takes us through the intricacies and varied management of early pregnancy loss. Then, Dr. Lang takes us through STEMI equivalent presentations as well as sneaky STEMI mimics! Finally, our education was rounded out with our pediatric triple threat. We discussed NRP and simulated resuscitation of a bradycardic neonate, practiced umbilical vein cannulation as well as considered a prolonged fever work-up in a case of Kawasaki and the intricacies of lumbar punctures in the pediatric population!
Read MoreJoin us for another week of Grand Rounds! We had a visit from Dr. Melissa Platt of the ABEM Board of Directors discussing the upcoming changes to the ABEM certification exam. Dr. Lawton presented to us about frequent fliers in the Emergency Department. Dr. Shewakramani spoke to us about sepsis metrics and operational changes that have been made in our department, and we closed with an exciting R3 Taming the SRU lecture with Dr. Artiga discussing difficult intubations.
Read MoreJoin us for another exciting week of Grand Rounds! Today we discussed capacity management and ED throughput, discussed best practices for bedside teaching and and giving a presentation, discussed disposition for orthopedic complaints in the community, reviewed skin adhesives and hypertensive emergency, and listened to a “year in review” of some of our most exciting ultrasound cases from the previous academic year.
Read MoreWe started off this week with our first morbidity and mortality conference of the year given by chief resident Dr. Moulds. Dr. LaFollette then shared clinical pearls with us from multiple case follow ups followed by Dr. Brower who discussed the evidence behind a multitude of superstitions. We finished up with a lecture from dual EM/PEM trained faculty Dr. Cindy Chang who discussed high risk, low prevalence diseases in children.
Read MoreWe started off this week with femoral nerve block case review with Dr. Lori Stolz, followed by our first ever morbidity and mortality conference focused on community practice given by Dr. Hughes. Next, Drs. Boyer and Benoit faced off in the clinical pathologic case lecture. Dr. Moulds covered high yield ophthalmology visual diagnosis, and Dr. Baxter discussed time sensitive vascular pathology. We finished off the day with Drs. Richards and Demel who discussed the operational aspects of stroke care.
Read MoreSepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world. Sepsis as a disease process has been difficult to both clearly define and quickly recognize. Many metrics for recognition and management of sepsis are dependent upon various scoring systems, including SIRS, SOFA, qSOFA, and MEWS, none of which were designed for the acute detection of sepsis within the emergency department. This journal club recap will look at an article by Knack et al looking at physician gestalt vs scoring systems for the detection of sepsis.
Read MoreWe started off this week with a lecture and small groups discussing different leadership styles. This was followed up by a fantastic discussion on interpersonal and community violence with Drs. Jarrell and Kimmel. We then reviewed all things early pregnancy ultrasound with the one and only Dr. Stolz and ended with a great review of landmark studies in EM with Dr. Freiermuth.
Read MoreIn patients with cirrhosis and ongoing bleeding, it can be challenging to determine whether or not patients are hyper or hypocoagulable. Traditional markers of coagulation status like INR can be difficult to interpret in patients with abnormal synthetic function and potentially increase consumption of coagulation factors. Can TEG (thromboelastography) be a helpful too in these situations? In this journal club recap, Dr. Grisoli recaps a recent article by Rout et al that addresses this issue.
Read MoreJoin us for the last Grand Rounds of the academic year! We discuss organophosphate toxicity and bubble CPAP in low-resource settings for Global Health Grand Rounds, a CPC case of acetaminophen toxicity, cardiac pacing, and a case of methemoglobinemia caused by pyridium!
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.
