'Roids to the Rescue?

'Roids to the Rescue?

Can the addition of high-dose methylprednisolone to the treatment of out-of-hospital cardiac arrest make a meaningful difference? In this post-hoc analysis of a placebo-controlled randomized control trial comparing high-dose methylprednisolone versus placebo in out-of-hospital cardiac arrest (OHCA), the authors aimed to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.

Read More

Grand Rounds Recap 03.13.24

Grand Rounds Recap 03.13.24

Another great week of Grand Rounds! We started with optimizing our wet reads on MSK xrays then moved into a victorious CPC win in the diagnosis of giant cell artertitis with a patient presenting with CN VI palsy and diplopia. We then discussed the tips and tricks for hernia reduction before hearing a moving story of a harrowing AirCare transport for ECMO cannulation. We moved into R3 small groups covering obstetrics and labor from mother to newborn and finished off with our pediatrics team visiting to discuss emergent cardiac conditions.

Read More

SQuID Protocol for DKA: Impact on ED Length-of-Stay

SQuID Protocol for DKA: Impact on ED Length-of-Stay

With the advent of fast-acting subcutaneous insulin analogs over the past 20 years, multiple studies have demonstrated that subcutaneous insulin protocols for treatment for treatment of mild-to-moderate severity DKA are safe and cost-effective when compared to intravenous insulin infusion protocols in non-ICU settings. In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions

Read More

Grand Rounds Recap 3.6.24

Grand Rounds Recap 3.6.24

We had another exciting week of Grand Rounds! We covered topics including our new hypoglycemia protocol with Drs. Beyde and Wolski to traumatic cardiac tamponade with Dr. Glenn to syncope roles with Dr. Kotei. We enjoyed a visiting lecture from our Ohio ACEP team talking about the role of ACEP in residency and beyond. We finished strong with a lecture from our program director Dr. McDonough talking about her take on wellness in residency!

Read More

Grand Rounds Recap 2.14.24

Grand Rounds Recap 2.14.24

Join us as we recap a very special week of Grand Rounds here at UCEM! We started off with Dr. David Wright, visiting us from Emory University, to discuss the very latest in ICH management and also share his pearls for developing into leaders in our field. Next, we are joined by Dr. Cheetham, a PEM attending and EMS fellow, who reminds us the importance of EMS handoffs and even offers ways we can improve the safety of our patients. Dr. Martella shares how his previous time spent working in fast food industry helped shape him into the dedicated and compassionate physician he is today. Followed by Dr. Lewis educating each of us on how to better recognize and manage acute-onset pulmonary edema in the crashing patient. Lastly, our PEM colleagues from CCHMC stop by to help us better diagnose and manage a child presenting to ED with a limp. This week certainly highlighted the collaborative nature of our speciality and we are beyond grateful for all our colleagues near & far that help make us into better providers!

Read More

Grand Rounds Recap 2.7.24

Grand Rounds Recap 2.7.24

Join us we recap another week of Grand Rounds. We start off with a CPC case, where Dr. Rodriguez challenges Dr. Benoit to a case involving a young child with recurrent syncopal episodes. Next up, Dr. Knudsen-Robbins teaches us all the tips/tricks to performing LPs in the ED. If you ever felt nervous about an pediatric airway, our airway expert, Dr. Carleton, walks us through all the nuances of a pediatric intubation. Meanwhile, Dr. Milligan reflects on her four years as a resident and shares her insight about making the hard decisions during training. One of our very own SRU tamers, Dr. Davis, teaches us how to expertly manage symptomatic bradycardia. Lastly, Drs. Broadstock and Ramachandran help us add nerve blocks to our growing toolbox used for treating acute pain in the ED.

Read More

Grand Rounds Recap 1.31.24

Grand Rounds Recap 1.31.24

We had a jam packed grand rounds this week, which started off with a simulation and ultrasound demonstration from our AirCare team. Next Dr. Vaughan took us through the dermatologic emergencies we cannot miss, and Dr. Ferreri discussed why every decompensated patient should receive an sonographic waves for assessment. We continued with our third installment of Landmark Studies of EM, covering the important papers on traumatic resuscitations. Finally, Dr. Bryant took us through a global health inspired case and Dr. Otten taught us about the medications that can be toxic to pediatrics in small doses.

Read More

Grand Rounds Recap 1.24.24

Grand Rounds Recap 1.24.24

This week at Grand Rounds we started off with a lively discussion of some unique case presentations during M&M presented by Dr. Yates. Drs. Wosiski-Kuhn and Stothers then walked us through the most pressing research papers in our Mini-Lit Blitz, followed by Dr. Benoit talking us through ideal Post-ROSC Care. Finally, our QI/KT on necrotizing soft tissue infections was expertly presented by Drs. Schor and de Castro.

Read More

Grand Rounds Recap 1.17.24

Grand Rounds Recap 1.17.24

Join us as we recap another fantastic Grand Rounds session. We started off with our longitudinal leadership curriculum, specifically focusing on recruitment and building a team. This was led by two prominent leaders in our very own emergency department- Drs. Fermann and LaFollette. Next, we join Dr. Finney on a journey as she reflects on the relationships we build with our patients and their families, as well as providing insight on how to cope with the grief that we may face following the most difficult cases. Lastly, Drs. Chhabria, Davis, and Gobble, help us prepare for the upcoming ITE exam by providing us with useful quick hits relating to orthopedic injuries, PEM, and toxicology.

Read More

Grand Rounds Recap 1.10.24

Grand Rounds Recap 1.10.24

We started off the day strong with a R4 Case Follow Up lecture presented by Dr. Yates who led an excellent discussion on psychosis, including maintaining a broad differential for secondary psychosis and appropriate management. We then transitioned to an R1 Clinical Knowledge lecture where Dr. Segev guided us through interstitial lung disease and fibrosis ranging from epidemiology to diagnosis and treatment. This then followed by a hand-on high acuity low opportunity procedure review including esophageal balloon tamponade, transvenous pacemaker placement, and chest wall escharotomy. The hands-on sessions continued into the afternoon where our CCHMC colleagues led a simulation on neonatal shock. Overall, a great day at UCEM Grand Rounds!

Read More

Grand Rounds Recap 1.3.24

Grand Rounds Recap 1.3.24

We are back and ready for our first grand rounds of the year! We had a great variety in lectures today. Dr. Wosiski-Kuhn shared her capstone on violence against healthcare workers. Dr. Martella followed up a case of a patient with a spontaneous coronary artery dissection and their puzzling ED clinical presentation. Dr. Guillaume helped us troobleshoot and optimize our options for vascular access including EJ cannulation, ultrasound-guided IVs and all things PICC line. Dr. Haffner took us through a pathophysiology and treatment review of a patient with a very large calcium channel blocker overdose. The R2 team of Drs. Della Porta and Hajdu presented their protocol on alcohol withdrawal in the ED. We learned about the use of panorex as a new study for certain dental patients in conjunction with oral surgery from Dr. Urbanowicz. Finally, Dr. Baez dropped some protips to be confident and competent at a busy community ED site.

Read More

Grand Rounds Recap 12.20.23

Grand Rounds Recap 12.20.23

This week we started off with a riveting M&M presented by Dr. Kletsel, where we discussed massive GI bleeds, renal abscesses, and more. This was followed by a face off for the ages between Drs. Beyde and Bonomo on an uncommon presentation of thyrotoxicosis. Finally, a group of R4s led us through an educational simulation of BRASH syndrome and some informational oral boards style cases.

Read More

Grand Rounds Recap 12.6.23

Grand Rounds Recap 12.6.23

What a great Wednesday at UCEM Grand Rounds! To start off the morning, we had the absolute honor to host NFL Players Association Medical Director Dr. Thom Mayer who guided us through a lesson on leadership via examples in the NFL. We then transitioned to our quarterly EMS grand rounds where we discussed updated Southwest Ohio EMS protocols with EMS fellow Dr. Weekley. Following this, we brought out our competitive sides by participating in a game of sports medicine jeopardy led by Dr. Betz, one of our sports medicine trained faculty members. Dr. Fabiano then gave an insightful capstone lecture on reflecting on what you want to do with your life, particularly outside of our careers. We then transitioned back to the clinical space for Dr. Snyder’s informative lecture on prosthetic valve emergencies. Finally, we wrapped up the day with a quality improvement and knowledge translation lecture about spontaneous intracerebral hemorrhage.

Read More