All that Pukes: Cyclic Vomiting Syndrome, Gastroparesis and More

All that Pukes: Cyclic Vomiting Syndrome, Gastroparesis and More

Nausea and vomiting accounts for one of the most frequent chief complaints we see in the emergency department. For those presenting with another complaint, N/V is often an associated symptom. Treatment of these symptoms not only improves patient satisfaction, but also decreases associated complications, like dehydration and electrolyte abnormalities.

The etiology behind a patient’s N/V is highly variable, with a broad differential that stretches across all organ systems. Although often an acute presentation, N/V is increasingly being linked to set of chronic disorders, such as gastroparesis (GP), cyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS). While the work-up and initial evaluation in the ED is similar for all, specifically ruling out potentially life-threatening diagnosis or complications, the clinical presentation and management vary subtly between these syndromes.

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Grand Rounds Recap 1.19.22

Grand Rounds Recap 1.19.22

This week’s Grand Rounds featured some amazing content! Starting with Dr. Paulsen, our leadership curriculum session focused on processing and learning from failure. We then discussed IV contrast extravasation with Drs. Milligan and Wosiski-Kuhn as they debuted their QI/KT protocol. Dr. Crawford reminded us of the dangers of carbon monoxide and we closed the day with an excellent introduction to the benefits of simulation-informed design with Visiting Lecturers Dr. Chris Hicks and Dr. Andrew Petrosoniak.

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Ultrasound of the Month: Clot in Transit

Ultrasound of the Month: Clot in Transit

Nothing is scarier than the patient that you suspect is going to decompensate in front of you, and nothing will make that case more than seeing a clot in transit on bedside echo. Join Dr. Wolochatiuk as she discusses the signs of right heart strain and management of a patient with clot in transit.

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Therapeutics: Platelet Coagulopathy Fixes with ITP, TTP and DIC

Therapeutics: Platelet Coagulopathy Fixes with ITP, TTP and DIC

Join Dr. Moulds as she dissects the difficult landscape of thrombocytopenia, where cause is king and sometimes the therapy can be more harmful than watchful waiting. Keep this one in your favorites for the next time a critical thombocytopenic patient rolls in…

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Grand Rounds Recap 1.12.22

Grand Rounds Recap 1.12.22

Joins us for another week of Grand Rounds as Dr. Moulds breaks down platelet disorders, Dr. Alden Landry joins us to discuss disparities in healthcare, Dr. Urbanowicz laughs her way through her R4 Capstone on the science of laughter, and we team up with our alloys at CCHMC PEM to learn about iron toxicity.

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Grand Rounds Recap 1.5.22

Grand Rounds Recap 1.5.22

During this week’s Grand Rounds, Dr. Walsh presented Morbidity and Mortality, Dr. Thode discussed complications of Group A Streptococcal infection, Dr. Harward oriented us to submersion injuries, Drs. Pancioli and Paul Gordon shared opportunities for medical device innovation and engineering collaboration, Dr. Brower shared pearls on facial fracture diagnosis and management, and Drs. Fabiano and Thompson went head-to-head in a CPC to diagnose thyrotoxicosis.

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Face the Music: Emergency Management of Facial Fractures

Face the Music: Emergency Management of Facial Fractures

Maxillofacial trauma is common in the emergency department as ~80% of patients with polytrauma sustain injuries to the head, face, and/or neck. The most common etiologies of facial fractures are: assault (36%), motor vehicle accidents (32%), falls (18%), sports injuries (11%), occupational injuries (3%), and gunshot wounds (2%).3 The most commonly fractured facial bones are (in descending order): nasal bones, orbital floor, zygomaticomaxillary complex, maxillary sinuses, mandibular ramus, and the nasoethmoidorbital. This post will review the general approach to evaluation of maxillofacial trauma in the ED followed by specific management recommendations for various fracture patterns.

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Grand Rounds Recap 12.15.21

Grand Rounds Recap 12.15.21

Join us for a recap of this week’s robust Grand Rounds. We have a wide array of topics including biliary pathology, ED operations and how are decisions impact boarding, congenital long QT and Boerhaave syndrome, TTP, and pediatric stridor.

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Grand Rounds Recap 12.1.21

Grand Rounds Recap 12.1.21

In this week’s Grand Rounds, Dr. Skinner introduces updates to EMS protocols , Dr. Gressick discusses thrombotic complications in COVID-19, Dr. Hunt shares her tips to avoid burnout in residency, Dr. Sobocinski walks us through nephritic and nephrotic syndromes, Dr. Yates challenges Dr. Hughes to diagnose an infected urachal remnant, and Drs. Broadstock, Comiskey, Kimmel, and Winslow discuss the diagnosis and treatment of uniquely Floridian dangers.

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