Grand Rounds Recap 12.11.19

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Grand Rounds Recap 12.11.19

This week in grand rounds started off with Dr. Humphries reviewing the evidence of various interventions in traumatic cardiac arrest and providing a clear algorithm to follow in patients who suffer blunt traumatic cardiac arrest. We then had an in depth discussion on the approach to the encephalopathic patient in the Emergency Department. Dr. Bryant then presented some interesting cases that she had on her most recent trip to Guyana, followed by Dr. Ramsey’s in depth review of the emergent complications of acute leukemia. We finished off the day with our pediatric Emergency Medicine colleagues who led us through a simulation and oral boards cases.

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Grand Rounds Recap 12.4.19

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Grand Rounds Recap 12.4.19

After a brief hiatus we returned to grand rounds this week and started off with an in depth discussion on common overdoses and treatments in the ED with our guest lecturer and expert toxicologist Dr. Gillian Beauchamp. We then got some hands on time with the new hand held ultrasound machines that are now available on Air Care as well as reviewed pre-hospital management of traumatic pneumothoaces with Dr. Humphries. Finally, airway guru Dr. Carleton took us on a deep dive on airway management in angioedema.

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Grand Rounds Recap 11.20.19

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Grand Rounds Recap 11.20.19

Dr. Golden kicked grand rounds off this week with our monthly morbidity and mortality conference, followed by Dr. Lane’s deep dive on massive pulmonary embolism in cardiac arrest and how to approach this. Dr. Owens then gave us a detailed review on a probably-more-common-than-you-think parasite that has started popping up in the US, and our excellent ED pharmacists gave us a crash course on common antidotes to various poisonings, overdoses, and bites that we frequently see in the ED. Finally, Dr. Ham finished up with a review of the importance of chronic hypertension in our ED population and how we can make a difference especially those with limited access to care.

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Air Care / Annals of B Pod Series: Hypokalemia

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Air Care / Annals of B Pod Series: Hypokalemia

Hypokalemia is a commonly seen laboratory abnormality which is often unappreciated in the emergency department. Join us as we take a deep dive into the presentation and life threatening consequences of a patient with severe hypokalemia as we review a previous case from an international leader in critical care transport medicine, Air Care.

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Grand Rounds Recap 11.13.19

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Grand Rounds Recap 11.13.19

This week was filled with Ultrasound pearls, starting with our guest lecture from Dr. Avila (5minutesono) on ocular ultrasound. We then covered how and when to perform musculoskeletal ultrasound with Dr. Broadstock, and witnessed a battle of wits between Dr. Urbanowicz and Dr. Minges over a case of uremic pericarditis. Dr. Humphries then showed us how to perform a flawless consultation, and several residents presented interesting learning points from the recent ACEP conference in Denver. Finally, Dr. Gray gave us a thorough review on the pearls and pitfalls of pediatric sedation.

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Diagnostics: Musculoskeletal Ultrasound

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Diagnostics: Musculoskeletal Ultrasound

Ultrasound continues to push into more and more of the physical exam, and nowhere is that clearer than in the musculoskeletal exam. From diagnosing and prognosticating patellar tendon ruptures and ligamentous injuries to being a procedural adjunct in shoulder dislocation to critical identification of necrotizing fasciitis, it continues to push boundaries. Dr. Broadstock gives us a look at some of the applications you need to make yourself a better practitioner in this week’s Diagnostics of Musculoskeletal US post.

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Grand Rounds Recap 11.6.19

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Grand Rounds Recap 11.6.19

This week Dr. Irankunda and Dr. Berger took us through their excellent QIKT on strangulation and asphyxiation. Dr. Knight walked us through the initial ventilator management in the ED. Dr. Habib talked about some common mythology and Dr. Makinen lead us through a physiologically challenging airway in a sick trauma patient. Ended with a thrilling R4 sim focusing on altitude illnesses.

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Prehospital Stroke Triage

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Prehospital Stroke Triage

Over the past 5 years, there has been a dramatic expansion of the treatment strategies used to treat patients with acute ischemic stoke. As some of these treatments involve specific resources only available at certain institutions, appropriate triage of patients in the prehospital environment is becoming ever important. On one hand a patient who would best benefit from endovascular treatment triaged to a center without that capability will undoubtedly suffer a delay in care. On the other hand, over-triaging stroke patients to a comprehensive stroke center could overwhelm the resources of that center, potentially impacting the care of patients at that center. In the podcast below, we talk with Dr. Jason McMullan of the UC EM Division of EMS and Dr. James Li, PGY-3 who both have recent publications focusing on this phase of patient care.

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Grand Rounds Recap 10.23.19

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Grand Rounds Recap 10.23.19

This week Dr. Banning discussed several practice-changing topics in our Morbidity and Mortality conference. Drs. Laurence and Wolochatiuk prsented their QIKT project for the management of acute, decompensated pulmonary hypertension, and Dr. Wright gave a fascinating presentation on the approach to fever in a returning traveler.

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Grand Rounds Recap 10.16.19

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Grand Rounds Recap 10.16.19

This week we disccused interventions for the crashing asthma patient with Dr. Mand, ESRD and dialysis related complications with Dr. Scanlon, shoulder and elbow xrays with Drs. Crawford and Scanlon, and a case of intussusception in an adult patient with Drs. Hunt and Bryant. Dr. Gauger provided his case follow up on PJP pneumonia complicated by methemoglobinemia, and Dr. Li took us through the ins-and-outs of gastric lavage in a simulated case of calcium channel blocker overdose.

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Air Care Series: No Lung No Problem - VV ECMO

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Air Care Series: No Lung No Problem - VV ECMO

No Lung? No problem! Join Liz Powell, Paige Barger and Adam Gottula as they take a look at the basics of VV ECMO in the transport environment.

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X-ray Vision - Shoulders and Elbows

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X-ray Vision - Shoulders and Elbows

Upper extremity trauma and pain related complaints are frequently encountered in the Emergency Department. In this post, we cover the basics of the anatomy of the shoulder and elbow joint, the radiographic studies frequently performed in the evaluation of shoulder/elbow injuries, and cover some commonly encountered injuries of these joints.

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Grand Rounds Recap 10.9.19

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Grand Rounds Recap 10.9.19

This week we continued our leadership curriculum with Dr. Pancioli’s lecture on the intersection of leadership and finance. This was followed by Dr. Klaszky with his R4 case follow up of a patient with cardiac tamponade, and then Drs. Baez and Continenza faced off for the most recent installment of our Great Debate series as they discussed chemical vs electrical cardioversion for atrial fibrillation. Finally, our colleagues from Cincinnati Children’s presented learning pearls about causes of and interventions for hypoxia in pediatrics emergency medicine.

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Grand Rounds Recap 10.02.19

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Grand Rounds Recap 10.02.19

In this week’s Grand Rounds we discussed spinal fractures and imaging of knees and hips with our R1s, Drs. Kimmel and Gressick. Dr. Hassani from the R2 class took on Dr. LaFollette with a case of thyrotoxicosis presenting as a-fib with RVR in his CPC, and Dr. Koehler from the R3 Class taught us about heroin/naloxone-induced pulmonary edema. Dr. Golden from the R4 class discussed Fournier’s Gangrene complicated by sepsis-induced cardiomyopathy, and finally our trauma surgery colleague Dr. Pritts discussed some hot topics in trauma.

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Sepsis Journal Club Roundup

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Sepsis Journal Club Roundup

The management of patients with sepsis can be exceptionally complex. As with many patient’s with complex critical illnesses, often times attention to seemingly minor aspects of the patient’s management can have significant impacts on the patient’s course of illness. In this recap of our most recent journal club, we review 3 such aspects of the care of patients with sepsis. Does the type of IV fluids really make a difference? Are steroids a friend or foe in the care of these patients? And can the simple bedside assessment of capillary refill replace serial measurements of lactate?

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