Grand Rounds Recap 04.14.21

/
Grand Rounds Recap 04.14.21

This week’s Grand Rounds was jam-packed with great morsels for all! Dr. Finney kicked us off with a discussion on orbital infections, Dr. Frederick discussed the nuances of dynamic EKG changes in the ED and consultation etiquette in her R3 Taming the SRU lecture, Dr. Iparraguirre discussed pearls of wisdom for his R4 Capstone, Dr. Kein expertly discussed the literature behind the most commonly used medications for agitation in the ED, Drs. Mullen and Ham battled head-to-head in a CPC case highlighting ethylene glycol toxicity, Dr. LaFollette presented a rare case of metformin-associated lactic acidosis, and lastly Dr. Runkle wrapped the day up with pearls for rural PEM.

Read More

Grand Rounds Recap 04.07.21

/
Grand Rounds Recap 04.07.21

This week in Grand Rounds we discussed the management of early pregnancy loss with OBGYN, things you don’t know you don’t know when you graduate with Dr. Paulsen, a case of tumor lysis syndrome with Dr. Laurence, an R4 case follow up with Dr. Hall, and our quarterly simulation with a myxedema coma case.

Read More

Droperidol for Agitation in the ED - No Danger to the Dangerous?

/
Droperidol for Agitation in the ED - No Danger to the Dangerous?

Droperidol is a versatile medication with a number of potential uses for patients in the Emergency Department. It is also a medication surrounded in some degree of mystique because of the decision by the FDA in 2001 to issue a black box warning for its use in response to reports of QT prolongation and torsades de pointes. Many at the time (and since) have argued that, despite these case reports, droperidol is a safe and effective medication that can be used for the treatment of agitation, nausea and vomiting, and migraine. We have previously covered much of this background in a previous blog post. In our most recent journal club, we discussed 3 articles that looked at the safety and efficacy of droperidol for treating acutely agitated patients. Take a read and listen below for an in depth look at each of these papers.

Read More

Grand Rounds Recap - EMS Disaster Day 03.31.21

/
Grand Rounds Recap - EMS Disaster Day 03.31.21

This week highlighted our annual EMS Disaster Day! From decontamination pearls with our guest lecturer Dr. James Augustine, to preparation planning and response with our very own Dr. Mel Otten, to Ebola updates and radiation injuries with Dr. Calhoun, to gun violence with guest lecturer Dr. Brian Springer, there are pearls for all!

Read More

Grand Rounds Recap 03.24.21

/

What’d we cover in this week’s Grand Rounds? Dr. Mand expertly delivered her final Morbidity & Mortality conference of the year, covering a spectrum of pathology from pediatric cardiac arrest to BRASH syndrome. Dr. Ryan gave the second part of the highly informative medical malpractice series. Dr. Stark reviewed hand injuries for her R1 Clinical Knowledge, an EM bread & butter lecture series. To cap things off, Dr. Hunt reviewed an R3 case where she tamed the SRU.

Read More

Grand Rounds Recap 03.10.21

/
Grand Rounds Recap 03.10.21

This week’s Grand Rounds started off with Journal Club covering everyone’s favorite medication, droperidol! We followed this with a blast from the past, alum and guest lecturer Dr. Iserson who delivered this quarter’s Global Health Grand Rounds. The Sports Medicine Interest Group gave key points on the hand, elbow, and hip exam. Finally, the day ended with video review of two pediatric resuscitations to make us all pause the next time we see the chief complaint “shortness of breath” pop onto the trackboard.

Read More

Open Breaks - Antibiotics for Open Fractures

/
Open Breaks - Antibiotics for Open Fractures

Open fractures are a common pathology seen in emergency departments, especially in trauma centers. In open fractures, the skin barrier has been compromised, exposing sterile bone to the environment. Considered a true orthopedic emergency, these fractures have high morbidity due to osteomyelitis, with infection rates up to 55%. (1) Appropriate and timely intervention in the emergency department with proper antibiotic therapy, wound care, and early orthopedic surgery involvement dramatically reduces the risk of developing osteomyelitis. In this post we will discuss antibiotic recommendations for osteomyelitis prophylaxis for open fractures. Initial management of open fractures is discussed in another post.

Read More

Open Breaks - Initial Management

/
Open Breaks - Initial Management

Open fractures are a common pathology seen in emergency departments, especially in trauma centers. In open fractures, the skin barrier has been compromised, exposing sterile bone to the environment. Considered a true orthopedic emergency, these fractures have high morbidity due to osteomyelitis, with infection rates up to 55%. (1) Appropriate and timely intervention in the emergency department with proper antibiotic therapy, wound care, and early orthopedic surgery involvement dramatically reduces the risk of developing osteomyelitis. In this post, we will review the management of open fractures and address additional complications from open fractures. Fractures of the axial skeleton (skull, facial bones, spine, ribs, and pelvis) will not be discussed in this post. Antibiotic recommendations for osteomyelitis prophylaxis are discussed in another post.

Read More

Your Migraine Cocktail Didn’t Work? Shake it Up!

/
Your Migraine Cocktail Didn’t Work? Shake it Up!

You’ve tried prochlorperizine, ketorolac and fluids and are about to triumphantly discharge the patient when they stop you and inform you they’re still in a debilitating pain. What’s your move? Join Dr. Martina Diaz as she reviews second line and alternative therapies in the management of acute headaches.

Read More