May 12, 2019

Grand Rounds Recap 5.8.19

May 12, 2019/ Guest User

Welcome to another installment of the Grand Rounds Recap! We had an excellent series of lecturers that we are very excited to share with you. We started off the day with our visiting lecturer Dr. Noble who presented a some excellent pearls on how to better incorporate lung ultrasound in the management of our patients in the ED. Next up Dr. Mand and Dr. Lagasse went head to head in our clincopathologic case series. Dr. Lagasse nailed the diagnosis of Dengue hemorrhagic fever and Dr. Mand then educated us on how it can progress to shock. To follow came Dr. Pulvino who lead us through some small group cases on the utilization of the PERC criteria and Wells score in the evaluation of patient with a potential pullmonary embolism. Next was Dr. Connelly who presented on the evaluation and management of patients with conditions resulting from ascent to high altitudes. To wrap up the day Dr. Lipshaw demystified the pediatric rash patient.

May 04, 2019

PERCs of the Wells Score

May 04, 2019/ Jeffery Hill, MD M.Ed

Pulmonary embolism (PE) is one of the big “can’t miss” diagnoses in the emergency department. Unfortunately, presenting symptoms are often vague, and definitive diagnostic testing is expensive and comes with risks of radiation and contrast to the patient. In order to avoid missing a PE while mitigating the risks associated with overtesting, some clinical decision tools have been created to aid in the diagnostic process. We will focus on two of these commonly used decision tools: the PERC rule and the WELLS score for PE.

May 03, 2019

Grand Rounds Recap 5.1.19

May 03, 2019/ Guest User

We had an exciting Grand Rounds this week. We started off with our visiting lecturer, Dr. Jennifer Wiler, who gave us an excellent overview of the dollars and cents behind the care that we provide in the emergency department. Afterwards we practice some oral board style cases. Dr. Betz led a challenging triple patient encounter where we had to simultaneously manage a knee dislocation, aortic dissection with involvement of the right coronary artery, and pneumonia in the setting of HIV. Dr. Curry led a riveting case of preeclampsia where identifying the critical history of a recent delivery was critical to initiating the correct management. We wrapped up the day with a simulation led by Drs. Hill, LaFollette, and Lang on in-flight emergencies!

May 01, 2019

A Headache with Consequences - Temporal Arteritis

May 01, 2019/ Jeffery Hill, MD M.Ed

This will mark the third and final recap of the March 2019 asynchronous small group cases. Feel free to take a look and listen back at Parts 1 and 2. This post we’ll be covering the presentation fo a middle aged female with a headache. The differential is broad and fraught with a number of life/limb/sight threatening diagnoses. As with the previous recaps, we recorded a podcast where we walk through the presentation, initial work up and management.

April 26, 2019

Grand Rounds Recap 4.24.19

April 26, 2019/ Timothy Murphy, MD

This week’s grand rounds started off strong with Morbidity and Mortality led by Dr. Baez. She discussed a wide variety of topics including stress testing in the ED, precautions, hearing loss, aspiration, and tamponade. Dr. Randolph followed this up with an insightful discussion on high risk ED discharges. The Global Health Team then shared some of the fascinating cases they encountered overseas. Dr. Sabedra reflected on how much we learn from each other by giving a heartfelt talk on what she has learned from her fellow R4’s. We continued with Dr. Gawron reviewing the many cervical spine rules and how to properly apply them. To conclude, Drs. Skrobut and Roche went head to head in this weeks CPC. Who wins? Read on to find out.

April 23, 2019

The Return of Droperidol...

April 23, 2019/ Jeffery Hill, MD M.Ed

Have you heard the news! Droperidol is back and available in the United States. After a prolonged hiatus the medication has been picked up by a new manufacturer and may be finding its way to a hospital pharmacy near you. Since it has been some time since the medication has been in common use, and since the memory of its effectiveness may be buoyed by a sense of nostalgia or otherwise viewed through rose colored glasses, now is as good a time as any to take a stroll through the literature and learn a bit more about the effectiveness and side effect profile of the medication.

April 19, 2019

Grand Rounds Recap 4.17.19

April 19, 2019/ Guest User

Enjoy this weeks Grand Rounds Summary. We had a great small group session on conflict resolution presented by Dr. McDonough and Leenellett of the leadership curriculum team. Next, Drs. Iparraguirre and Li taught us about an evidence-based approach to epistaxis. We completed our morning going through a great simulation on Acute Myocardial Infarction requiring Thrombolysis with Drs. Colmer, Mckee, Harrison, and Continenza.

April 12, 2019

Grand Rounds Recap 4.10.19

April 12, 2019/ Guest User

Have fun reading this week’s Grand Rounds Recap! Dr. McDonough provided an insightful talk on Physician Depression and Wellness to start our morning. Following this, we had an excellent session on TEG’s multitude of uses in the ED. We had a variety of ophthalmology pearls shared by Drs. Owens, Scanlon, Ventura, and Harty. Then, Dr. Krack, one of Cincinnati Children’s Hospital’s Pediatric EM fellows shared helpful hints in taking care of pediatric patients with Congenital Heart Disease. Next, Dr. Pulvino shared her clinical diagnostics lecture on Platelet Disorders. Dr. McKee finished our day with an exciting talk on medical ethics and how they apply to the Emergency Department. Enjoy!

April 10, 2019

The A Fib Chicken and Egg - III Recap

April 10, 2019/ Jeffery Hill, MD M.Ed

This is the first in a series of 3 blog posts recapping our residency’s most recent asynchronous small group exercise. For these posts, we’ll start with a case vignette and then highlight some key aspects of the presentation and cover some key learning points. You can also take a listen to the accompanying podcast for a slightly more in depth look at the case.

March 29, 2019

Grand Rounds Recap 3.27.19

March 29, 2019/ Guest User

Enjoy this week’s Grand Round’s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!

March 27, 2019

Telling Tall Tales: Dogma in Emergency Medicine

March 27, 2019/ Jeffery Hill, MD M.Ed

In our training and education as Emergency Medicine providers, we often come to accept certain practice patterns as fact. When these established “facts” come along with fantastical clinical claims (don’t give your corneal abrasion patients tetracaine, it’ll melt their corneas; don’t use lido with epi for digital blocks, their finger will fall off; don’t use beta-blockers in patients on cocaine, their BP will skyrocket due to unopposed alpha-effects), we should probably look to question their supporting evidence.

March 22, 2019

Grand Rounds Recap 3.20.19

March 22, 2019/ Guest User

Enjoy this week’s Grand Rounds Recap! Dr. Jordan Bonomo started us off with a fascinating talk on brain death, and how therapeutic hypothermia in the post-arrest patient can make this diagnosis more challenging. Next up, Dr. Harrison taught us some pearls on management of the bradycardic peri-arrest patient. Dr. Nagle shared with a us how to rescuscitate a patient with acute aortic dissection. Lastly, Dr. Summers talked to us about PRES and how to recognize and treat this rare disorder.

March 14, 2019

Grand Rounds Recap 3.13.19

March 14, 2019/ Jessica Baez

This week’s Grand Rounds began with a practical discussion of the CBC and differential by Dr. Hassani. Dr. Hughes and Thompson led a fantastic CPC on a case of myxedema coma, and Dr. Whitford discussed CT over-utilization in the emergency department. We finished the day with our pediatrics colleagues who walked us through anxiety-provoking cases of aortic coarctation, bacterial tracheitis, and neonatal jaundice. Check it out!

March 12, 2019

Grand Rounds Recap 3.6.19

March 12, 2019/ Jessica Baez

From surgical airways to the undifferentiated shock patient, this week’s Grand Rounds was packed full of clinical pearls. Dr. Carleton started with a discussion of a tachycardia-inducing failed airway requiring cricothyrotomy. Drs. Jensen and Makinen presented a very detailed review of the literature and their proposed algorithm on infective endocarditis. Dr. Harty reviews a fascinating case of cecal volvulus that was identified early with the aid of a RUSH exam, while Dr. Liebman walked us through an approach to the patient with inhalation injuries. Finally, Dr. Roblee led an excellent review of SBP. The discussion was full of information you might use on your next shift!

March 10, 2019

The CBC and the Man Behind the Curtain

March 10, 2019/ Jeffery Hill, MD M.Ed

It’s been called “the refuge of the intellectually destitute (physician)” by Amal Muttu. The CBC is a much maligned test that is nevertheless one of the the most frequently ordered diagnostic tests in the ED. To truly know how to interpret this test, one must understand its individual components, the possible causes of variations from normal for those components, and how it integrates into the clinical presentation of the patient. Also, it can’t help but to know and understand some of the historical background…

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