In the penultimate Grand Rounds of 2017 Drs. Klaszky and Spigner gave us an in-depth look of the evidence behind treatment of asthma in the ED and walked up through their new QI/KT pathway. Dr. Summers provided a great review of the resuscitation of the burn victim. We closed things out with our quarterly PEM-EM combined simulation sessions which included cases of children with difficulty breathing, seizure and stridor.
Read MoreWe had a jam packed Grand Rounds this week kicked off by Dr. Carleton's airway lecture discussing tools to maximize fiberoptic intubation success. Next Drs. Roche and Plash led us through wilderness medicine small groups discussing plant ingestions and creative extrication techniques. Drs. Murphy-Crews and Bryant participated in a CPC case with a seizing neonate followed by Dr. O'Brien's discussion of blunt neck trauma. Next Dr. Cotton presented data on physician burnout and how to combat it while Dr. Li wrapped things up with an overview of Kawasaki's disease.
Read MoreIt's late into your shift when a 12 month-old rolls into your trauma bay and have reproducible abdominal pain. Do you go straight to CT? LFTs? UA? Dr. Shan Modi takes us through the literature and utility of laboratory studies and EKGs in pediatric trauma.
Read MoreLast week we introduced to you a primer on the interpretation and detection of heart blocks on EKGs. Now you can test out your knowledge with some cases based on the information in the previous post!
Read MoreThis week Dr. Lagasse gave us a great M&M covering intra-ocular foreign bodies, empyema management in the ED and septic cardiomyopathy. Dr. Iparraguirre lead small groups in EKG case studies in heart blocks, followed by Drs Nagle and LaFollette squaring off in a CPC of an undifferentiated patient with aphasia. Drs Goel and McKee wrapped up this week with a clinical soapbox on patient turnover and a case follow up of lytics in massive PE.
Read MoreWe order and interpret numerous EKG’s during our shifts in the emergency department. EKG interpretation is one of the skills we need to be competent in and comfortable with as an emergency medicine physician. STEMI’s, ischemic changes and arrhythmias are some of the most important findings we focus on, and although straightforward, heart blocks can be easily overlooked. The goal of this post is to go over some of the most common and clinically relevant conduction blocks, how to manage them and what their disposition are.
Read MoreIn this week's Grand Rounds, we had the honor of our guest lecturer, ED/critical care pioneer Dr. Kyle Gunnerson, teach us about ED ECMO and implementing the concept of the ED-ICU. That was followed by our Air Care Grand Rounds curriculum with a mix of hands-on practical learning, didactics and simulation sessions.
Read MoreThis week, we started things off with a great Quarterly Sim led by our faculty. The oral boards cases, led by Drs Stettler and Roche, involved an acute presentation of holiday heart, a post-partum patient with flash pulmonary edema, and a very questionable spider bite. The simulation, led by Drs Fernandez, Hill and Stolz, focused on two patients that were in shock: one due to a ruptured ectopic pregnancy and one due to a pericardial tamponade. We then moved on to the pediatric side of things, where Dr. Gleimer discussed neonatal rashes, and we took a look at pediatric syncope with Dr. Fananapazir.
Read MoreDr. Ludmer kicked things off with this month's Morbidity & Mortality conference where we discussed C. Diff, spinal cord compression, LP in the setting of anticoagulation and cardiac arrest with an LVAD. Dr. Stettler led the next segment of our longitudinal leadership curriculum with a look at the mentor/mentee relationship. We finished up with a soapbox lecture by Dr. Titone on conflict resolution and an R3 follow up by Dr. Bernardoni who discussed the crashing patient with right ventricular failure and pulmonary arterial hypertension.
Read MoreGlobal is local. It is important as health care providers that we think about infectious diseases in terms of a global context. Reemerging infectious diseases represent a constant moving target for physicians and scientists. Understanding some of the factors behind disease reemergence as well as examples of current reemerging infectious diseases helps to illustrate how local changes can have a global effect.
Read MoreAs Emergency Physicians, we pride ourselves on taking care of critically ill, undifferentiated patients. As technology as advanced, we’ve been able to add more and more tools to our arsenal to help guide the management of these patients. One such tool is cardiac ultrasonography. It is able to give us dynamic information about the patient, rule out life threatening pathology such as tamponade, and even help guide resuscitation in cardiac arrest. All of this, however hinges on the physician having the knowledge and skills to employ this in our fast paced environment. Are your skills up to snuff? Find out after the jump!
Read MoreA handful of infectious disease focused trivia questions for your enjoyment and edification!
Read MoreThis week Dr. Gottula gave us a great in-depth explanation into alloimmunization and the use of RhoGAM in the ED. Dr. Owens and Faryar participated in a CPC centered around a sickle cell patient with knee pain. Dr. Asghar from orthopedics discussed the management of spine fractures in the ED. Our visiting professor Dr. Gail D'Onofrio discussed the ongoing opioid abuse issues facing the country. Dr. Hall discussed industrial injuries while Dr. Polsinelli wrapped things up with a discussion about how to use EMR to report core measures.
Read MoreThe risk of alloimmunization in pregnancy is one the EP faces every day, but what are we preventing? when do we need to consider increasing our RhoGAM dosing? and do you really need a type and screen for the same patient in the same pregnancy? Dr. Gottula gets to the bottom of the type and screen and presents a rational algorithm for working up the Rh status of the pregnant patient in the ED.
Read More5 Questions and Answers to Test your Knowledge of Bedside Cardiac Ultrasound
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.
