Not every swollen leg was made equal, nor should they all be treated the same. In the second installment of our case series, join us on the discussion of a rare vascular complication of the lower extremities.
Read MoreHave 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!
Read MoreThis 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.
Read MoreThromboelastography (TEG) may be less ordered than traditional coagulation studies, however gives much more specific and detailed information to your patient’s coagulopathy. Join Dr. Wolochatiuk as she explores the indications and interpretations of the TEG.
Read MoreEnjoy 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!
Read MoreIn 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.
Read MoreEver have a patient that looks more concerning than their EKG? Perhaps their ischemia is in that anatomically difficult to access right ventricle or even posterior. Join Dr. Connelly in looking at the utility of right sided, posterior and Lewis leads and bring something new to your next chest pain patient.
Read MoreEnjoy 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.
Read MoreYour pregnant patient gets rushed in uncomfortable and just shying of pushing but you have a few minutes to panic. Why panic when you can grab a probe and get some information about your impending delivery? Dr. Bernardoni guides us through the LABUR exam and the finer points of the term OB POCUS.
Read MoreThis 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!
Read MoreFrom 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!
Read MoreIt’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…
Read MoreThe headache is the simplest and most complex we see on a daily basis in the ED, but it is important to consider, on both ends, how the coagulation cascade can go awry and be a causative source. Dr. Gawron walks us through a patient presenting with an unprovoked and rather discourteous dural venous sinus thrombosis, its natural history, and appropriate emergent evaluation and management.
Read MoreSpinal cord injuries are nothing to shake your head at, though. As Dr. Jensen eloquently dissects in his review of neurogenic shock, emergency physicians can play a tremendous role in the ultimate outcomes of patients with vasodilatory shock secondary with the prompt recognition and appropriate management of spinal cord pathology.
Read MorePneumonia. It’s one of the first conditions we learn to diagnose as medical students. It was probably the cause of the first really sick, septic geriatric patient you saw in residency. Conversely you have also probably sent a fair share of patient’s home with an outpatient course of antibiotics and PCP follow-up. While determining the appropriate treatment and disposition for patients on the extreme ends of illness severity is quite straight forward; that pesky majority in the middle can be a conundrum at times. Who can go home? Who needs broad spectrum? Who needs step-down? Over the last two decades there has been a smorgasbord of pneumonia related acronyms used in clinical practice to predict severity, guide therapeutics and recommend disposition. During our most recent resident Journal Club, we took a look at a handful of the more familiar acronyms as well as some new ones coming down the pipeline.
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.
