Anion Gap in you obtunded ingestion patient? Weekend gone dry and friends digging through the back of the cabinet? Join Dr. Kimmel as she discusses the diagnostics and therapeutics in toxic alcohol injections and when in doubt, bookmark this for a quick review of their toxicities and metabolites.
Read MoreThis week started with some nutritional tips (and treats that cannot be shared on the recap) of how to get through a shift (and life) eating quality over quantity. This was followed by lecture of the best cases of the year by Dr. Benoit, contracts and bedside teaching small groups and Sports Medicine guru Dr. Betz took us through Hand cases in our community series discharge, transfer or admit.
Read MoreFlank pain and pain due to ureterolithiasis are common ED presentations. There exist, however, a number of controversies when you dive into the literature addressing the diagnosis and treatment of nephrology/ureterolithiasis. Is IV lidocaine effective at treating pain in these patients? Is there a way to avoid CT scans? What about tamsulosin? Is it only good for big stones/small stones? Is there a benefit at all. For our most recent Journal Club, we tackled several of these controversies. Take a listen to the podcast below or over on iTunes.
Read MoreThis week Dr. Kathryn Banning led us in our first Morbidity and Mortality conference of the year. Dr. Banning led us through robust discussion about concurrent pathology presentations, biases and more. Air Care Grand Rounds followed, in which we reviewed aircraft operations and logistics with the Air Care team and went through a simulation case that highlighted the importance of stress inoculation.
Read MoreGrand Rounds this week started with our Leadership Curriculum, focusing on both positive and negative attitudes of leaders. Next, Dr. Hughes gave her Taming the SRU follow up lecture on debriefing and fat embolism syndrome followed by Dr. Spigner’s R4 Case Follow Up Lecture on streptoococcal toxic shock syndrome. The week wrapped up with simulation and oral boards practice covering acute right heart failure and anterior uveitis.
Read MoreMusculoskeletal ultrasound is a burgeoning field of study, which can be used to augment physical exam in the emergency department. This month’s ultrasound case delves into the meat and potatoes of Achilles tendon scanning, plus a quick hit on the bad boy of antibiotics - fluoroquinolones
Read MoreNot every bradycardic patient is the same, however sometimes their past history gives away their pathology and you need to manage a complex disease in the ED or in transit to the ICU. Remind yourself of the details of the cardiac action potential as Dr. Roblee walks us through a unique case of Long QT Syndrome.
Read MoreWe had a great week in Grand Rounds. The first lecture included a debate about the use of rocuronium or succinylcholine in paralysis for intubation by Drs. Lang and Plash. Drs. Ryan and Moellman led a thrilling discussion through some of their most interesting and thought provoking cases of their careers. Pharmacists Nicole Harger and Paige Gaber then discussed updates in pharmacy, specifically the use of droperidol and anticoagulation reversal in the emergency department. We learned about cognitive biases and clinical decision making from Dr. Hill. The day wrapped up with Dr. Knight showcasing the NIH stroke scale with Dr. Foreman.
Read MoreCellulitis with or without abscess - a common problem with a stamp-like treatment of antibiotics. Should every skin and soft tissue infection (SSTI) get the same remedy? Is there a role for risk factors or ultrasound in risk stratification of additional coverage? Join Dr. Laurence for a dive into the current literature of SSTI coverage.
Read MoreThe reality of the Emergency Department is that not everybody is sick, but every patient could be sick. The task of finding the sick patients among the non-sick is far more challenging than it may appear and the diagnostic process is far more fraught with potential sources of error than one would like.
Read MoreWelcome to the new Academic Year! We started the year off with Dr. Pancioli giving us some context of how EM got to where it is and where it is going. Dr Palmer then inspired us to consider our role in the teamwork that is patient care. Dr McDonough then led us in an exercise of delivering bad news to patients, and some of the nuance that is dealing with breadth of reactions to it.
Read MoreVentricular dysrhythmias are commonly caused by coronary ischemia which is most frequently caused by acute coronary artery occlusions in the setting of coronary artery disease. It would seem somewhat logical that patients who suffer a V fib or V Tach cardiac arrest would benefit from a trip to the cardiac catheterization lab to identify and treat these possible acute coronary artery occlusions. Patient’s with EKGs showing ST-elevations following ROSC already go to the Cath lab. Since the EKG is not terrifically sensitive for MI, should V fib V Tach cardiac arrest patients without ST-elevations make a trip to the Cath lab? In this breakdown of our most recent journal club we look at several papers covering this topic. In the podcast below we also talk with Justin Benoit, MD the site PI for the ongoing ACCESS trial which is also looking into this question.
Read MoreThis week was the last grand rounds of the academic year. We started off with the monthly Morbidity and Mortality conference led by Dr. Colmer. This was followed up by a CPC on Infectious Mononucleosis from Dr. Jensen and Dr. Stolz. Dr. Urbanowicz then discussed if there is a use of platelet function studies in the Emergency Department. The day ended with Dr. Murphy-Crews describing a fascinating case of severe hypothermia and outlining the interventions available to us in the ED for these patients. See you next week!
Read MoreGall bladder wall thickening prompts thoughts of cholecystitis in the mind of most emergency physicians. But it’s not always that simple. Join Dr. Roblee as she takes us through a case of cholecystitis that… isn’t.
Read MorePlatelet transfusion is a hotly debated topic and practice pattern variation is high, which is a great time to get back to the basics. Dr. Urbanowicz gets back to the basics of platelet function assays and the conflicted role of transfusion if they are deemed dysfunctional
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.
