In this journal club recap, Dr Sarah Moulds recaps a recent meta-analysis of papers looking at the therapeutic effect of TXA in patients with severe trauma. Are their higher rates of thromboembolic complications? Is mortality improved? This article by Fouche et al attempts to answer these questions.
Read MoreOut of hospital cardiac arrest (OOHCA) represents a great cause of morbidity and mortality. Approximately 350,000 cardiac arrests occur in North America annually and 20% can be attributed to Ventricular tachydysrhythmias (i.e. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse). In this journal club recap, Dr Kelly Tillotson recaps an article comparing different ways of defibrillation and their effect on outcomes in OOHCA
Read MoreJoin Dr. Stark for M&M tips from the last session of the academic year. Also we have electrical storm management, ethical considerations of patient care, neck injury management.
Read MoreCan clean gloves (those in the box in the room) be used safely during the repair of traumatic lacerations in the ED? Should we break open the package of sterile gloves each time? This Journal Club recap covers a recent paper examining the use of clean vs sterile gloves for wound repair in the ED.
Read MoreAnother week, another great Grand Rounds line-up at UCEM. We start off with our monthly Mortality and Morbidity Conference led by Chief Resident Dr. Finney. This session covers cases from the month of April- including the treatment of a canine in the SRU. One of our SRU leaders, Dr. Chhabria, shares the changing landscape of cardiac arrest management using ECMO. Next up, Dr. Thompson helps us reflect on the self-talk that we engage in on a daily basis and offers advice on how to improve our mindset- especially when we are on-shift. We learn from Dr. Kotei how to better ED proceduralists when encountering patients with ascites and/or pleural effusions. We end with Dr. Hajdu challenging Dr. Baez to solve a puzzling case of progressive vision loss in a otherwise healthy young patient.
Read MoreWe started off this Wednesday with guest lecturer Dr. Susan Wilcox who joined us for Air Care ground rounds. This was followed by the top 10 Air Cases of the academic year presented by Drs. Tillotson and Hinckley. This was followed by Dr. Kletsel’s thoughtful R4 capstone, and we wrapped up with R3 small groups with Drs. Glenn, Haffner, and Jackson who covered topics from in flight emergencies, venomous snakes, and environmental emergencies.
Read MoreRecap another week of Grands Rounds with us! Dr. Gabor helps us confidently navigate the medical emergencies in patients with a transplanted organ. Next up, Dr. Kein talks about the difficulty of navigating grief while completing residency training. Dr. Hill introduces use to research topics in the field of medical education. Our faculty who trained at other institutions, Drs. Adan and Lang, highlight different regional practice pattern variations and the evidence behind them. Meanwhile, Dr. Roche helps us learn how to better care for our female patients in the community. Lastly, we wrapped up with a joint lecture with the Cincinnati Children’s PEM program to learn out handling pediatric foreign bodies in the ED.
Read MoreJoin us as we recap another excellent week of Grand Rounds. We start with the final installment of our leadership curriculum, where Drs. Hill and LaFollette guide us through the dreaded task of self-promotion. We join Dr. Stark on a moment of self-reflection and growth following a particularly difficult patient case. We are transported into the SRU as Dr. Wright presents the evidence for how we should approach traumatic cardiac arrests in the resus bay. Dr. Adan shares his airway expertise and provides helpful tips/tricks for overcoming the feared anterior airway. Lastly, our colleagues from pharmacy drop by to discuss some relevant updates- including reasons why you should think twice before ordering a urine culture in the ED.
Read MoreWe started off this Wednesday with the crowd favorite M&M by Dr. Kletsel covering fantastic learning cases. This was followed by an expert discussion of neuromuscular weakness by Dr. Onuzuruike, and a quick hit EKG lecture by Dr. Urbanowicz on EKG artifacts. We wrapped up this day of discussion with our social emergency medicine grand rounds and our quarterly Landmark Studies of EM focusing on critical care.
Read MoreWelcome to Disaster Day! UCEM learned about a broad range of topics today from active shooter incidents, climate change and how it affects our approach to disaster medicine, and mass casualty preparedness.
Read MoreSepsis is a leading cause of mortality for hospitalized patient’s both worldwide and in the United States. The surviving sepsis guidelines weakly recommend invasive arterial blood pressure monitoring (IABP) over noninvasive blood pressure monitoring (NIBP) with a blood pressure cuff supported by low quality evidence.(1) Data comparing the accuracy between IABP and NIBP measurements are limited. The largest analysis of 736 critically ill patients found a mean difference of 1 mmHg which was not statistically significant, however, there was only one measurement recorded per patient.(2) Arterial lines have several drawbacks compared with non-invasive methods such as: training requirements for caregivers, potential for pain and increased pain medications, limitation of participation in physical therapy, risk of digital ischemia, and risk of iatrogenic infection.(3) In this journal club recap, we analyze an article looking at the relationship between invasive arterial line blood pressure readings and non-invasive cuff measurements.
Read MoreA hernia is described as, “the abnormal protrusion of abdominal contents through a defect involving the normal confines of the abdominal compartments” (9). It often involves a portion of the intestine protruding through a weak point of the abdominal wall. The location and size of the hernia often determines the symptoms and complications that a patient will present with.
There are several risk factors that make developing a hernia more likely. Older patients and those who have had prior abdominal surgery may have weaker abdominal muscles or connective tissue which would make it easier for a hernia to develop. In addition, if there is increased abdominal pressure, such as patients with obesity, or those who participate frequently in weightlifting, this is another factor that may put someone at a higher risk of developing a hernia. Finally, those with poor wound healing, such as people who smoke often or patients with diabetes, may be at risk for incisional hernias. (6)
Read MoreAn excellent Wednesday here in Cincinnati! We started out the day with our ultrasound grand rounds where ultrasound fellow Dr. Broadstock took us through an interactive lecture on advanced cardiac ultrasound. This was followed by a lecture by faculty member Dr. Irankunda who discussed the importance of names and embracing individuality. Finally, we ended the day with a combined session with our pediatric colleagues where we covered pediatric procedures, foreign body aspiration, and a neonatal potpouri. We can’t wait for next week!
Read MoreWe had an excellent Grand Rounds this week! Dr. Yates led our monthly Morbidity & Mortality Conference discussing pathology ranging from Dabigatran overdose to acute limb ischemia. We had an exciting CPC with hypomagnesemia presenting as new onset psychosis with Drs. Joshi & Lang. Finally, Dr. Gallen led a lecture and small group discussion on tracheostomies and their complications.
Read MoreWe had an exciting Grand Rounds this week! Dr. Ben Bassin, a UCEM alum and our visiting lecturer from the University of Michigan, started off strong discussing innovation in emergency care delivery. He discussed modeling and design of modern emergency departments and our upcoming Flex ICU. Dr. Grisoli then shared an exciting resuscitation of a profoundly hypothermic cardiac arrest. We split off into small groups for simulation and oral boards covering tuberculosis, meningitis and the RV spiral of death.
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.
