To Appendectomy or Not to Appendectomy: The Alvarado Score

/
To Appendectomy or Not to Appendectomy: The Alvarado Score

Appendicitis is the most common surgical emergency that emergency physicians encounter each year. The prevalence of appendicitis in the US is estimated at 7%, with an incidence of 9.38 per 10,000 people annually [1,2]. Appendicitis shares many signs, symptoms, and laboratory features with other acute medical and surgical conditions, including diverticulitis, nephrolithiasis, and ovarian pathologies like tubo-ovarian abscess and ovarian torsion. Diagnostic tools such as the Alvarado score are designed to help emergency clinicians sharpen their diagnostic acumen by stratifying the likelihood of appendicitis based on scoring systems

Read More

Grand Rounds Recap 4.8.20

/
Grand Rounds Recap 4.8.20

This week there were a number of underlying themes between pacemakers, MIs and leadership as well as some other high yield topics sprinkled in. Dr. Broadstock kicked us off with an educational lecture on pacemakers. We combined with our neurology colleagues to discuss how to best take care of basic neuro complaints in the ED in the time of COVID. R3s led an awesome small group on high sensitivity troponin. Dr. Banning shared the lessons she has learned through her own mistakes and failures. A truly heroic resuscitation for a patient in R heart failure by Dr. Skrobut in his Taming the SRU lecture. Lastly, learned about pediatric ophthalmology from Dr. Zamor.

Read More

Updates in Pediatric Cardiac Arrest

/
Updates in Pediatric Cardiac Arrest

Pediatric cardiac arrests are, potentially, some of the most challenging patients for an emergency physician to care for. Cognitively, emotionally; these patients push us to our very limits. In this journal club recap, we cover 3 recently published articles looking at the care of these patients. Should survivors be cooled? Is Epi any good? Which is better amiodarone or lidocaine?

Read More

Diagnostics: Flex your D Dimer

/
Diagnostics: Flex your D Dimer

In times of COVID, a Dimer of 3000 is nothing to look twice about, however there was an earlier (and future) time where the D Dimer is the hallmark of pulmonary embolism risk stratification. Dr. Comiskey breaks how how this once dichotomous tool has recent data to increase its specificity in elderly patients, pregnant patients and those with low pretest risk factors. Take a look, and when this whole pandemic is over your quiver will be fuller of Dimer tips.

Read More

Grand Rounds Recap 4.1.20

/
Grand Rounds Recap 4.1.20

As we continue our teleconferenced grand rounds, we started with a timely review of ARDS management and refractory hypoxemia with Dr. Shaw, two successful faculty guessed CPCs presented by Drs Irankunda and Pulvino and finally Dr. Jarrell gave us a much needed break with a baking show from her kitchen, with an included recipe for a mug cake!

Read More

Grand Rounds Recap 03.25.20

/
Grand Rounds Recap 03.25.20

In our first ever teleconferenced Grand Rounds - this week Dr. Kathryn Banning presented us with opportunities to improve the care we deliver in our monthly morbidity and mortality conference. Then, our panel of expert clinicians and self-aware humans engaged us all in a discussion of wellness and longevity that was at times vulnerable and candid, but also enlightening from start to finish. Finally, we learned more about radio operations and reflected on both failures and victories in HEMS CQI cases with our Air Care leadership team.

Read More

Grand Rounds Recap 3.11.20

/
Grand Rounds Recap 3.11.20

This week’s Grand Rounds started with a great Airway Grand Rounds lecture by Dr. Carleton. Dr. Frankenfeld led a discussion on face and mouth infections followed by Dr. Li’s Taming the SRU lecture on loperamide overdose. We had a great lecture by Dr. Thompson about healthcare change methodology. The week wrapped up with pediatric simulation focusing on ultrasound.

Read More

10 Things I hate about you: FAST edition

/
10 Things I hate about you: FAST edition

The FAST is one of the most commonly utilized sonographic examinations in the modern emergency department, which also means that it represents one of the most frequent opportunities for error. In this month’s post, Dr. Owens illustrates the pitfalls you should avoid to become an ultrasound aficionado in trauma.

Read More

Grand Rounds Recap 3.4.20

/
Grand Rounds Recap 3.4.20

We had an outstanding week in Grand Rounds, led off by a visiting lecturer and UC EM Class of 2013, Dr. Renee Salas. Dr. Salas is currently Assistant Professor at Harvard Medical school and a Yerby Fellow at the Center for Climate, Health, and Global Environment. Her talk was entitled “Climate Crisis and Clinical Practice - Implications for Emergency Medicine.” Next, Dr. Baez presented a fascinating Ultrasound Grand Rounds with Ultrasound M&M. Drs. Frederick and Walsh led us through their new clinical pathway for Non-Pregnant Vaginal Bleeding in their QI/KT. Dr. Klaszky gave his R4 Clinical Capstone lecture on how to make effective presentations.

Read More

Mastering Minor Care: Management of Migraines

/
Mastering Minor Care: Management of Migraines

Sometimes finding a way to treat a migraine in a patient can induce a migraine in ourselves! Join Dr. Zalesky in learning about the diagnosis of migraines, the red flags associated with the diagnosis, and learning how to best manage a patient that walks through your emergency department doors with disabling migraine.

Read More

What to do about the Flu?

/
What to do about the Flu?

It’s the height of flu season and our most recent Journal. Club focused on a couple of papers digging into the treatment of influenza as well as the association of cardiovascular events with influenza infections. Take a read and a listen to hear about the utility (or potential lack thereof) of oseltamivir as well as the evidence behind a newer medication for treatment of influenza, baloxavir.

Read More