Swelling out of the Blue - Angioedema in the ED

Swelling out of the Blue - Angioedema in the ED

Angioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat. While it is not pruritic it may be painful. In the US, angioedema accounts for approximately 100,000 ER visits annually (1). Across the world, 35% of prescriptions written for hypertension are for ACE-inhibitors (>40 million people). With a reported incidence of angioedema in 0.1–0.7% of those patients on ACEI, there are approximately 40,000 cases of ACEI-associated angioedema worldwide annually (2).

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Grand Rounds Recap 08.05.20

Grand Rounds Recap 08.05.20

This week’s Grand Rounds started off with Dr. Paulsen walking us through how to create an enriching learning environment for our students and junior residents in the Emergency Department. Dr. Gleimer then presented an inspirational R4 Case Follow Up of a v.fib cardiac arrest that lived to tell the tale on his experience and second lease on life. Lastly, Drs. Gottula and Skrobut skillfully demonstrated best practice patterns for managing STEMI patients in helicopter EMS transport.

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Grand Rounds Recap 7.29.20

Grand Rounds Recap 7.29.20

This week’s Grand Rounds was kicked off with Dr. Mand presenting our first Morbidity and Mortality Conference of the academic year. Dr. Carleton then masterfully provided tips on how to improve airway management. Drs. Yates and Modi led us through our first Clinical Treatment lecture series outlining the evidence-based medicine approach to managing elevated intraocular pressure. Drs. Meigh and Jarrell discussed a fascinating case of neurosyphilis for CPC, and finally, Dr. Jensen walked us through his tips and tricks for approaching individual finances.

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Grand Rounds Recap 07.22.20

Grand Rounds Recap 07.22.20

This week’s Grand Rounds was full of teamwork, sports medicine, fast-paced lecturing, and just a little rivalry. Whether you’re a fan of the R2 CPC format or the R4 Case Follow-Up, this week’s summary is sure to be a crowd pleaser. Also including Dr. Benoit’s lit of practice changing EM articles of the last year - with links!

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Grand Rounds Recap 07.15.20

Grand Rounds Recap 07.15.20

For this week’s Grand Rounds, Dr. Paulsen covered mentorship, an active process, as part of UCEM’s longitudinal leadership curriculum. Dr. Lang covered the history, educational theory, and future of simulation and gamification to help us spruce up our next lecture. To cap it off, Dr. Iparraguirre led an excellent simulation on refractory V-Fib requiring ECPR activation given UCMC’s newly released protocol.

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Grand Rounds Recap 07.01.20

Grand Rounds Recap 07.01.20

The first Grand Rounds of the 2020-21 academic year was full of inspiration. Dr. Pancioli, Department Chair, walked us through the history of emergency medicine and gave us a glimpse into UCMC’s new ED plans. Dr. McDonough, Program Director, highlighted that professionalism is a series of actions that can be modified to improve our leadership presence. Dr. Knight, critical care trained faculty, reminded us that we are the masters of the undifferentiated patient, providing tips on how to approach the almighty question, “Sick or not sick?”

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Grand Rounds Recap 06.24.20

Grand Rounds Recap 06.24.20

The final Grand Rounds of the 2019-20 academic year offered an incredible line up of lectures followed by an annual residency program evaluation and wrap-up by the outgoing chief residents, lovingly called “KJAM”.

Dr. Golden presented our monthly Morbidity and Mortality conference, full of cases to learn from and improve clinical care. Dr. Shaw presented his Taming the SRU lecture on a case of massive hemoptysis in an otherwise young and healthy patient. Dr. Murphy-Crews delivered a moving R4 Capstone lecture, demonstrating the low NNT for ED thoracotomies and highlighting that resilience is not the issue when it comes to burnout and physician suicide.

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Grand Rounds Recap 6.17.20

Grand Rounds Recap 6.17.20

Dr. Gauger started us off with a truly inspiring R4 capstone reminding us all to respect our patients and treat them with compassion and empathy. Dr. Hall's taming the SRU led us through an interesting case of severe metabolic acidosis. Lastly, Drs. Leech and Roblee presented a truly stellar QIKT evidence based protocol on hepatic encephalopathy.

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Grand Rounds Recap 6.10.20

Grand Rounds Recap 6.10.20

This week we reconvened with our pediatric colleagues for a case series of seizures and COVID autoimmune vasculitis. Drs Modi, Harty and Jarrell took us through global health case series and finally guest lecturer Dr. Kenji Inaba from LAC-USC gave us some take-home tips in hemorrhage management.

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