Grand Rounds Recap 12.2.20

Grand Rounds Recap 12.2.20

We had a great Grand Rounds with nine lectures!

Dr. Fermann gave us operations updates for the CEC. Dr. Dave Thompson discussed quality improvement, root cause analysis, and the Pareto Principle. Dr. Tillotson walked us through the types of hypertension seen in pregnancy and how to manage these patients. Dr. Walsh found a sandwich in a patient’s airway. Dr. Jarrell discussed the exciting specialty called Social Emergency Medicine. Dr. Koehler showed us how to use a Minnesota tube for massive UGIB. Dr. Milligan discussed complex cardiac devices including IABP, Impella, and LVAD. Dr. Hassani reviewed post partum headaches and evidence on neuroprotective intubation. And lastly, Dr. Gleimer made us exercise our System 1 and System 2 thinking.

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Grand Rounds Recap 11/18

Grand Rounds Recap 11/18

What do these 3 things have in common: interval prolongation, COWS, and rural America? All 3 were covered in this week’s UCEM Grand Rounds.

Dr. Li starting us off with monthly Morbidity & Mortality. Cards consultant Dr. Ahmad provided rapid fire EKG review. Dr. Stark refreshed us on opioid withdrawal treatment. And, Dr. Makinen delivered a moving capstone on the importance of rural emergency medicine.

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Grand Rounds Recap 11.11.20

Grand Rounds Recap 11.11.20

In this jam packed week Dr. Stolz started us off with lower extremity ultrasound and the ultrasound theme continued with Dr. Skrobut’s case follow up on cardiac tamponade. Two R1s presented on transfusion reactions and septic arthritis. Our PEM colleagues discussed pediatric rashes. Finally Dr. Ryan Knight gave a Veteran’s Day special on emergency medicine in the austere environment.

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Grand Rounds Recap 11.04.2020

Grand Rounds Recap 11.04.2020

This was a jam packed week that started with an EMS lecture from one our fellows, Dr. Morgan, about community paramedicine and mobile integrated healthcare. Dr. Mand’s case follow up focused on how to cope with grief in the emergency department. Dr. Kletsel gave us a literature based update on treatments of dental infections. Drs. Betz and Goff faced off in a CPC. Finally Drs. Gottula, Jensen, and Lane gave an intense simulation.

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Grand Rounds Recap 10.28.20

Grand Rounds Recap 10.28.20

Check out this week’s Grand Rounds Recap! Dive into colitis on CT via M&M with Dr. Koehler. Understand and treat cardiogenic shock with Drs. Kimmel and Broadstock. Share some laughs and learn about eyes with Visiting Professor Dr. Glaucomflecken. Disposition abnormal cardiac rhythms as seen in the community with Dr. LaFollette

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Grand Rounds Recap 10.21.20

Grand Rounds Recap 10.21.20

Dr. Freiermuth kicked off this week’s Grand Rounds with a recap of how to approach research in EM. Dr. Leech demonstrated the value to hemorrhage control and fistula complications. Drs. Harty and Comiskey faced off in a CPC case of DRESS syndrome and finally Drs. Gottula and Skrobut gave our quarterly Air Care Grand Rounds on HEMS stroke management.

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Grand Rounds Recap 10/14

Grand Rounds Recap 10/14

Reviewing our own neuroimaging just got a little easier with expertise shared by Dr. Knight. Trauma resuscitations just got a little more evidence-based with Journal Club covering VL>DL, IO>IV, and arginine vasopressin administration. Our kindness, attitude, and desire to take breaks all can improve with the help of Dr. Li’s R4 Capstone. Finally, Quarterly Sim/Oral Boards covered the spectrum of pediatric DKA with cerebral edema, to PTA, to trauma in the elderly, highlighting the breadth and depth of emergency medicine.

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Non-Invasive Estimation of Optimal PEEP

Non-Invasive Estimation of Optimal PEEP

As a general rule, mechanical ventilation of obese patients is more complex and difficult than in those with a normal body habitus. Obese patients have decreased chest wall compliance due to increased truncal adiposity, amongst other factors. They are also predisposed to other comorbidities that can lead to more involved physiologic challenges.

Critical Care Transport teams commonly transport patients who are intubated and mechanically ventilated. These patients are intubated for a variety of reasons, from altered mental status to hypercapnea to hypoxia. One of the more common challenges we face in our patients who are mechanically ventilated is difficulty with oxygenation – whether the patient is suffering primary or secondary hypoxemic respiratory failure.

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Grand Rounds Recap 10.07.20

Grand Rounds Recap 10.07.20

This week’s Grand Rounds offers a potpourri of topics, from Change Leadership via the Leadership Curriculum by Drs. McDonough & Fermann, to fundamentals and pearls of female GU infections by Dr. Fabiano, to a deep dive on hypermobility type of Ehlers-Danlos Syndrome by Dr. Jensen, to neonatal abdominal pain by Dr. Thomas (CCHMC PEM Fellow).

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Grand Rounds Recap 09.30.20

Grand Rounds Recap 09.30.20

This week’s Grand Rounds was full of excellent cases, Bayesian statistics, and uncovered cognitive biases.

From Morbidity & Mortality Conference by Dr. Hughes, to airway expertise by Dr. Carleton, to tips to decrease stress by Dr. Koehler, to learned lessons from near misses by attendings Dr. Continenza, R. Thompson, and Sabedra, this summary is one you’re going to want to pay attention to!

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Grand Rounds Recap 09.23.20

Grand Rounds Recap 09.23.20

Join us as we welcome our guest lecturer, Dr. Luke Messac, for our Global Health Grand Rounds. Dr. Modi then expertly takes us through the ED management of traumatic brain injury in his R4 Case Follow Up. Dr. Diaz makes her lecture debut with dermatologic emergencies. Drs. Winslow and Zalesky walk us through the evidence-based approach to neonatal resuscitation in their QI/KT, and lastly, we end the day learning about the power of positive psychology in our Wellness Curriculum.

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Grand Rounds Recap 09.16.20

Grand Rounds Recap 09.16.20

Join us as we explore our EMS Grand Rounds with Dr. Gray, discussion of pain management in pediatrics with Dr. Bryant, and the evidence-based approach to pericarditis treatment with Drs. Stevens and Jensen. Drs. Chuko and LaFollette then go head-to-head in our beloved CPC, Dr. Martella takes us through the diagnosis and management of myasthenia gravis, and Dr. Berger outlines the importance of taking care of our critically ill patients with humanity and kindness in his R3 Taming the SRU lecture. Lastly, Dr. Gottula wraps up with a discussion on how to excel at the little things during his R4 Capstone.

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A Fix for a Stinging Heart - Pericarditis Treatment in the ED

A Fix for a Stinging Heart - Pericarditis Treatment in the ED

Pericarditis is inflammation of the pericardial sac. Classically, pericarditis presents with sharp and pleuritic chest pain which is relieved by sitting up and forward. Pericarditis has multiple etiologies, but is most commonly idiopathic, assumed to be viral, in developed countries (1). Treatment of pericarditis should be targeted to the underlying etiology if possible (1). For presumed viral, idiopathic causes, most patients are treated with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine (1).

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Grand Rounds Recap 9.9.2020

Grand Rounds Recap 9.9.2020

The week started off with an anxiety inducting lecture on medical malpractice. Not to be outdone our PEM colleagues gave us a simulation with a 29 week premature delivery. This was followed by a review of different long term tubes that are in our patients. We were honored to have Drs. Mallory and Unaka give us a lecture on structural racism and how this has impacted racism in medicine, as well as how we can do better.

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Ketamine Potpourri

Ketamine Potpourri

In our most recent journal club, we took a look at 3 articles focused on the use of ketamine in the Emergency Department. When treating pain with ketamine, does a rapid administration of ketamine result in more dysphoria? When used for RSI, is ketamine more hemodynamically stable than etomidate? When using ketamine for procedural sedation in adult patients, does pre-treatment with versed or haldol decrease clinically significant emergence agitation?

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